Journal article
Evaluation and Management of Primary Spontaneous Pneumothorax in Adolescents and Young Adults: A Systematic Review From the APSA Outcomes Evidence-Based Practice Committee
Journal of pediatric surgery, v 58(10), pp 1873-1885
01 Oct 2023
PMID: 37130765
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Introduction: Controversy exists in the optimal management of adolescent and young adult primary spontaneous pneumothorax. The American Pediatric Surgical Association (APSA) Outcomes and Evi-dence-Based Practice Committee performed a systematic review of the literature to develop evidence-based recommendations. Methods: Ovid MEDLINE, Elsevier Embase, EBSCOhost CINAHL, Elsevier Scopus, and Wiley Cochrane Central Register of Controlled Trials databases were queried for literature related to spontaneous pneumothorax between January 1,1990, and December 31, 2020, addressing (1) initial management, (2) advanced imaging, (3) timing of surgery, (4) operative technique, (5) management of contralateral side, and (6) management of recurrence. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed. Results: Seventy-nine manuscripts were included. Initial management of adolescent and young adult primary spontaneous pneumothorax should be guided by symptoms and can include observation, aspiration, or tube thoracostomy. There is no evidence of benefit for cross-sectional imaging. Patients with ongoing air leak may benefit from early operative intervention within 24-48 h. A video-assisted thoracoscopic surgery (VATS) approach with stapled blebectomy and pleural procedure should be considered. There is no evidence to support prophylactic management of the contralateral side. Recur-rence after VATS can be treated with repeat VATS with intensification of pleural treatment. Conclusions: The management of adolescent and young adult primary spontaneous pneumothorax is varied. Best practices exist to optimize some aspects of care. Further prospective studies are needed to better determine optimal timing of operative intervention, the most effective operation, and manage-ment of recurrence after observation, tube thoracostomy, or operative intervention.Level of Evidence: Level 4. Type of study: Systematic Review of Level 1-4 studies.(c) 2023 Elsevier Inc. All rights reserved.
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Details
- Title
- Evaluation and Management of Primary Spontaneous Pneumothorax in Adolescents and Young Adults: A Systematic Review From the APSA Outcomes Evidence-Based Practice Committee
- Creators
- K. Elizabeth Speck - C. S. Mott Children's HospitalShannon N. Acker - University of Colorado DenverRobert Baird - British Columbia Children's HospitalAlana L. Beres - Drexel UniversityHenry Chang - Johns Hopkins All Children's HospitalBrian Englum - University of Maryland, BaltimoreKatherine W. Gonzalez - St. Luke's Children's HospitalAkemi Kawaguchi - Memorial HermannLorraine Kelley-Quon - Childrens Hosp Los Angelos, Los Angeles, CA USATamar L. Levene - Joe DiMaggio Children's HospitalRebecca M. Rentea - Children's Mercy HospitalKristy L. Rialon - Texas Children's HospitalRobert Ricca - University of South CarolinaStig Somme - Childrens Hosp Colorado, Aurora, CO USADerek Wakeman - University of RochesterYasmine Yousef - Montreal Children's HospitalJoanne E. Baerg - Presbyterian Healthcare ServicesAfif N. Kulaylat - Penn State Milton S. Hershey Medical CenterS. Christopher Derderian - Children's Hospital ColoradoShawn D. St Peter - Children's Mercy HospitalLucas, DJ
- Publication Details
- Journal of pediatric surgery, v 58(10), pp 1873-1885
- Publisher
- Elsevier
- Number of pages
- 13
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:001080074800001
- Scopus ID
- 2-s2.0-85154546618
- Other Identifier
- 991021969476304721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Pediatrics
- Surgery