Çocukluk çağı primer spontan pnömotoraks olgularına yaklaşım

Abstract

Objective: To present the follow-up and treatment experiences of two centers regarding primary spontaneous pneumothorax (PSP), which is rare in childhood, in the light of the literature. Methods: Age, gender, height, body mass index (BMI), complaint, radiological findings, pneumothorax percentages, follow-up and treatment records of patients with PSP who admited to two centers between 1 August 2016 and 1 August 2021 were retrospectively analyzed. Results: A total of 23 patients were included in the study. Twenty-one (91.3%) patients were male, 2 (8.7%) were female, and the mean age was 16.4±0.6 years. Mean height was 180.8±7.9 cm, and BMI was 21.1±2.6 kg/m2. The main complaints were chest pain, respiratory distress, cough and shoulder pain. Chest X-ray was taken in all patients. Computed tomography (CT) was performed in 9 patients (40.9%) who had persistent air leaks, developed recurrence and whose diagnosis could not be determined by X-ray. Conservative treatment (nasal oxygen 2-4 lt/min) was performed to 5 patients with pneumothorax percentage below 15% at the first admission, and tube thoracostomy in 18 patients. Video-assisted thoracic surgery (VATS) was performed in 8 (36.3%) cases. Recurrence developed in 4 (18.1%) cases. Conclusion: There is no standard approach in the diagnosis, treatment and follow-up process of childhood PSP. We think that new and prospective studies are needed in order to provide a standard approach on this issue. We think that VATS is an effective surgical method in the treatment. In addition, we considered that CT can be a useful diagnostic tool in management of PSP.