• Am J Emerg Med · Jul 2021

    Meta Analysis

    Comparison of efficiency and safety of conservative versus interventional management for primary spontaneous pneumothorax: A meta-analysis.

    • Wan-Li Liu, Kun Lv, Hong-Shen Deng, and Qiong-Chuan Hong.
    • The Department of Cardiothoracic Surgery, Longgang Central Hospital of Shenzhen, Address: No. 6028 Longgang Avenue, Longgang District, Shenzhen, PR China; Zunyi Medical University, No.6 Xuefu West Road, Xinpu New District, Zunyi City, China.
    • Am J Emerg Med. 2021 Jul 1; 45: 352-357.

    BackgroundThere is growing opinion that primary spontaneous pneumothorax (PSP) patients without hemodynamic compromise could be safely and successfully managed with observation alone. The aims of this meta-analysis were to estimate the safety and effectiveness of conservative treatment compared with that of interventional management as the initial treatment option for patients with PSP.MethodsThe PubMed, Embase and Cochrane library databases were systematically searched for randomized controlled trials (RCTs) and cohort studies (prospective or retrospective) until April 25, 2020, that compared conservative treatment and interventional treatment as the initial treatment for patients with PSP. The primary outcomes were success rates and recurrence rates. The secondary outcome was complication rates. Data extraction and quality assessment from eligible studies were independently conducted by two reviewers.Results8 trials with a total of 1342 patients were identified. The success rates of conservative management were similar with interventional treatment, with a risk ratio 1.05 (95% confidence interval 0.94 to 1.17, I2 = 69.1%). There was no significant difference of recurrence rates between these two type managements. (RR, 1.43, 95% confidence interval 0.45 to 4.55, I2 = 86.7%). Complication rates were lower in conservative treatment group (13 of 215 [6.05%]) than in interventional treatment group (57 of 212, [26.89%]), although the difference did not reach statistical significance (RR, 0.15, 95% CI, 0.02 to 1.13, I2 = 56.7%).ConclusionsResults of the meta-analysis suggest that conservative treatment offers a safe and effective alternative as compared with interventional management as the initial treatment approach for patients with PSP. However, more randomized clinical trials are need to provide more strong evidence to confirm our results.Copyright © 2020. Published by Elsevier Inc.

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