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Result Summary for Survey: Management of Initial Spontaneous Pneumothorax
The survey on management of initial spontaneous pneumothorax provided some interesting results. Most surgeons manage such patients with a small bore catheter or chest tube, and rarely utilize observation or aspiration. Despite randomized studies demonstrating the utility of drainage and sclerosis in reducing the risk of recurrent pneumothorax, few surgeons perform sclerosis as part of nonoperative therapy for these patients. Most surgeons responding to the survey indicated they would wait a week before determining that chest tube drainage had failed. A surprisingly small number of respondents use talc or other agent to perform sclerosis as part of an operation for pneumothorax. Most surgeons preferred mechanical abrasion or pleurectomy, in spite of experimental studies that demonstrate that a sclerosing agent is more effective than mechanical abrasion for this purpose.
What is your preferred initial therapy for this patient? | |||
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Response Percent |
Response Count |
|
a. Observation with oxygen therapy | ![]() |
5.9% | 7 |
b. Aspiration | ![]() |
7.6% | 9 |
c. Thoracic vent or other small bore catheter connected to a valve apparatusd. | ![]() |
22.7% | 27 |
d. Chest tube placement with suction or water seal | ![]() |
63.9% | 76 |
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answered question | 119 | |
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skipped question | 0 ![]() |
What role does drainage and non-operative chemical pleural sclerosis play in the management of this patient? | |||
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Response Percent |
Response Count |
|
a. I never sclerose such patients through a drainage tube | ![]() |
84.9% | 101 |
b. Sclerosis is best used in a patient whose air leak stops within a day or two | ![]() |
2.5% | 3 |
c. Sclerosis is best used in a patient whose air leak is slow to resolve | ![]() |
7.6% | 9 |
d. I use sclerosis routinely in the management of such patients. | ![]() |
5.0% | 6 |
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answered question | 119 | |
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skipped question | 0 ![]() |
When should surgical intervention be considered for such patients? | |||
![]() |
Response Percent |
Response Count |
|
a. If the air leak or pneumothorax fails to resolve after two or three days | ![]() |
37.8% | 45 |
b. If the air leak or pneumothorax fails to resolve after a week | ![]() |
53.8% | 64 |
c. Surgical intervention should be a routine part of the initial management of such patients. | ![]() |
8.4% | 10 |
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answered question | 119 | |
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skipped question | 0 ![]() |
What approach do you use for surgical management of such patients? | |||
![]() |
Response Percent |
Response Count |
|
a. VATS with small ports only | ![]() |
79.0% | 94 |
b. VATS with an accessory incision | ![]() |
9.2% | 11 |
c. Minithoracotomy (anterior, lateral, or axillary) | ![]() |
10.1% | 12 |
d. Standard thoracotomy | ![]() |
1.7% | 2 |
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answered question | 119 | |
![]() |
skipped question | 0 ![]() |
If a pleural procedure is included as part of your standard operation, what procedure do you use? | |||
![]() |
Response Percent |
Response Count |
|
a. Mechanical abrasion | ![]() |
47.9% | 57 |
b. Pleurectomy | ![]() |
39.5% | 47 |
c. Talc or other chemical pleurodesis | ![]() |
11.8% | 14 |
d. Pleural tent | ![]() |
0.8% | 1 |
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answered question | 119 | |
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skipped question | 0 ![]() |
Which specialty initially manages patients with primary spontaneous pneumothorax at your institution? | |||
![]() |
Response Percent |
Response Count |
|
a. Emergency medicine | ![]() |
22.0% | 26 |
b. Pulmonary medicine | ![]() |
19.5% | 23 |
c. General surgery | ![]() |
5.9% | 7 |
d. Cardiothoracic surgery | ![]() |
52.5% | 62 |
![]() |
answered question | 118 | |
![]() |
skipped question | 1 ![]() |
In what region is your surgical practice based? | |||
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Response Percent |
Response Count |
|
a. North America | ![]() |
47.9% | 57 |
b. Europe | ![]() |
36.1% | 43 |
c. South America | ![]() |
4.2% | 5 |
d. Asia | ![]() |
9.2% | 11 |
e. Africa | ![]() |
2.5% | 3 |
![]() |
answered question | 119 | |
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skipped question | 0 ![]() |