자연기흉의 치료에 있어 소구경 카테터 흉강삽입술의 유용성
Small Caliber Catheter Drainage in the Treatment of Spontaneous Pneumothorax
의학과 흉부외과학 전공
흉부외과 자연기흉 소구경 카테터;
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Purpose: Small caliber catheter drainage is proposed and attempted as alternative modality due to the invasiveness of closed thoracostomy. The purpose of this study is to examine the effectiveness of the small caliber catheter (7.0 Fr) in treatment of spontaneous pneumothorax, which is less invasive, and relatively easier procedure compared to closed thoracostomy. Methods: This study included 90 spontaneous pneumothorax patients who visited Emergency Department of Kyungpook National University Hospital and treated with small caliber catheter from January to December 2003. We investigated success rate, existence of underlying pulmonary disease, total number of incidence at the time of visit, size of pneumothorax, number of days to re-expansion, days of hospitalization, and rates of recurrence by reviewing medical records retrospectively. The treatment was considered successful when there was no air leakage and little or no residual pneumothorax 3 hours after small caliber catheter drainage. Results: The mean age was 30.4±15.6 years old, and there were 79 (87.8%) males and 11 (12.2%) females with average hospitalization of 3.25±3.16 days. The treatment was successful in 61 patients (67.8%) and failed in the remaining 29. The conventional large caliber chest tube was inserted in 16 of the 29 failures, but they were successful in only 5. The success rate was 76.7% (23/30), 78.6% (33/42), and 27.8% (5/18) in size 20-39%, 40-79%, and greater than 80% respectively (p=0.000). The others did not influence the outcome. Conclusion: Small caliber catheter drainage can be considered as the initial treatment of choice for spontaneous pneumothorax, especially in the pneumothorax with a size of smaller than 80%.