• Pengzhi Zhu, Honggang Xia, Zhongyi Sun, Deqing Zhu, Limin Deng, Yongmin Zhang, Haiquan Zhang, and Dongbin Wang.
• Department of Cardio-Thoracic Surgery, Tianjin Hospital, Hexi District, Tianjin, China.
• Interact Cardiovasc Thorac Surg. 2019 Jun 1; 28 (6): 936-944.

ObjectivesAlthough primary spontaneous pneumothorax (PSP) is an extremely frequent pathology, there is still no clear consensus on the treatment for these patients. We performed a strict meta-analysis on the effectiveness of manual aspiration (MA) compared to chest tube drainage (CTD) for the treatment of PSP.MethodsA literature search was performed on PubMed, EMBASE and the Cochrane Library to identify randomized controlled trials comparing MA with CTD for the treatment of PSP. Independent reviewers evaluated the methodological quality of the included randomized controlled trials. Statistical heterogeneity among studies was quantitatively evaluated using the I-squared index.ResultsFive randomized controlled trials were included, and a total of 358 subjects were reported on. We found that MA was related to significantly shorter hospital stays [in days; mean difference -1.70, 95% confidence interval (CI) -2.36 to -1.04; P < 0.00001, fixed effect model] compared with CTD. However, no significant differences were found between the 2 treatments for immediate success rate (risk ratio 1.15, 95% CI 0.73-1.81; P = 0.54), 1-year recurrence rate, 1-week success rate, time of recurrence, chest surgery rate or complication rate. Subgroup analysis showed that MA can provide a significantly lower hospitalization rate than CTD with a tube size of >12 Fr or a water seal drainage system.ConclusionsOn the basis of the currently available literature, MA is advantageous in the treatment of PSP because of shorter hospital stays. The subgroup analysis also indicates that MA can provide a lower hospitalization rate than CTD with a tube size of >12 Fr or a water seal drainage system. However, there are no significant differences between the 2 interventions with respect to immediate success rate, 1-year recurrence rate, 1-week success rate, time of recurrence, chest surgery rate or complication rate.© The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

12 keywords...

hide…