Objective: to explore the outcomes between the early or delayed air drainage for spontaneous pneumothorax.
Methods: the present prospective study was designed to evaluate the efficacy and complications. 242 patients with primary spontaneous pneumothorax were randomly allocated to early (< 72 h) group (n = 142) or delayed (> 6 d) exhaust air group (n = 122), the recent success rates, average time in hospital, recurrences rates, and pleura adhesion rates were evaluated.
Results: average time in hospital: early group and delayed group respectively was (18 ± 6) d vs (6 ± 2) d. In early group, the amount of pneumothorax was between 20% to 50%, 51 cases were aspirated and 44 of them were increased after first aspiration, whom were subsequently treated by intercostal drainage. Size of pneumothorax more than 50%, 98 patients treated by intercostal drainage.12 of 142 patients with persistence leak air transferred to surgery. In delayed group, all of 122 aspirations were successful at the first time. There were significant differences between the 2 groups in recent successful rate. 29 of the 128 patients in early group and 5 of the 115 had a relapsing pneumothorax. During the 2 year follow-up period, 79 of the 128 patients in early group and none of the 115 had radiographic pleural adhesions appearances.
Conclusion: the time of air drainage was associated with outcomes of primary spontaneous pneumothorax. These data suggest that delayed intervention is an effective initial treatment strategy for patients with PSP, with a shorter time in hospital, fewer pleural adhesions and lower recurrence rates.