Consensus StatementsManagement of Spontaneous Pneumothorax
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| Pneumothorax type | ||
|---|---|---|
| Primary | Secondary * | |
| Type of intraoperative bullectomy procedure | ||
| Staple bullectomy | Preferred management† (VG)‡ | Preferred management (VG) |
| Hand-sewn bullectomy | Acceptable rarely (G) | Indeterminate (SC) |
| Laser-ablation ullectomy | Acceptable rarely (G) | Acceptable rarely (G) |
| Bullous electrocoagulationÛ | Indeterminate (NC) | Indeterminate (NC) |
| No bullous intervention | Inappropriate (VG) | Inappropriate (VG) |
| Type of intraoperative pleurodesis | ||
| Parietal pleurectomy (total or partial) | Acceptable management (SC) | Acceptable management (SC) |
| Talc poudrage (insufflation) | Indeterminate (NC) | Acceptable management (SC) |
| Intraoperative chemical pleurodesis (not talc) | Inappropriate (VG) | Acceptable rarely (SC) |
| Parietal pleural abrasion | Preferred management (G) | Acceptable management (G) |
| Fibrin pleurodesisÛ | Indeterminate (NC) | Acceptable rarely (SC) |
| Extent of pleural abrasion or pleurectomy | ||
| Apical lung or apical chest wall only | Certain circumstances (G) | Certain circumstances (G) |
| Upper half of lung or upper half of chest wall | Preferred management (G) | Preferred management (G) |
| Whole lung or whole chest wall | Certain circumstances (G) | Certain circumstances (G) |
| Diaphragm (visceral or parietal) | Acceptable rarely (G) | Acceptable rarely (G) |
| *Buttressed stapled bullectomy offered as a management option for SSP only during questionnaire iteration 3 (last iteration): the result was "acceptable management" (NC). †See Table 5—Management Definitions. ‡Levels of consensus (Table 4) appear in parentheses after option: P = perfect, VG = very good, G = good, SC = some consensus, NC = no consensus. ÛThis management option only offered during questionnaire iteration #3 (last iteration). ??||Blood pleurodesis offered as a management option for SSP only during questionnaire iteration 3 (last iteration): the result was "usually inappropriate" (G). |
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