Jost Schnell1, Meinrad Beer2, Stephan Eggeling3, Wolfgang Gesierich4, Jens Gottlieb5, Felix J F Herth6, Hans-Stefan Hofmann7, Berthold Jany8, Michael Kreuter9, Julia Ley-Zaporozhan6, Robert Scheubel10, Thorsten Walles11, Sebastian Wiesemann12, Heinrich Worth13, Erich Stoelben14. 1. Lungenklinik Köln-Merheim, Lehrstuhl Thoraxchirurgie der Universität Witten-Herdecke, Witten-Herdecke, Germany, schnellj@kliniken-koeln.de. 2. Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm, Ulm, Germany. 3. Klinik für Thoraxchirurgie, Vivantes Klinikum Neukölln, Berlin, Germany. 4. Klinik für Pneumologie, Asklepios-Fachkliniken München Gauting, München Gauting, Germany. 5. Klinik für Pneumologie, Medizinische Hochschule Hannover, Hannover, Germany. 6. Abteilung für Pneumologie und Beatmungsmedizin, Thoraxklinik Universitätsklinikum Heidelberg, Heidelberg, Germany. 7. Abteilung für Thoraxchirurgie, Universitätsklinikum Regensburg, Regensburg, Germany. 8. Medizinische Klinik - Schwerpunkt Pneumologie und Beatmungsmedizin, KWM Missioklinik, Würzburg, Germany. 9. Klinik und Poliklinik für Radiologie, Klinikum der Ludwig-Maximilans-Universität München, München, Germany. 10. Klinik für Thoraxchirurgie, Fachkliniken Wangen, Wangen, Germany. 11. Abteilung Thoraxchirurgie, Universitätsklinik für Herz- und Thoraxchirurgie Magdeburg, Magdeburg, Germany. 12. Klinik für Thoraxchirurgie, Universitätsklinikum Freiburg, Freiburg, Germany. 13. Pneumologische und kardiologische Praxis Fürth, Fürth, Germany. 14. Lungenklinik Köln-Merheim, Lehrstuhl Thoraxchirurgie der Universität Witten-Herdecke, Witten-Herdecke, Germany.
Abstract
In Germany, 10,000 cases of spontaneous pneumothorax are treated inpatient every year. The German Society for Thoracic Surgery, in co-operation with the German Society for Pulmonology, the German Radiological Society, and the German Society of Internal Medicine has developed an S3 guideline on spontaneous pneumothorax and post-interventional pneumothorax moderated by the German Association of Scientific Medical Societies. METHOD: Based on the source guideline of the British Thoracic Society (2010) for spontaneous pneumothorax, a literature search on spontaneous pneumothorax was carried out from 2008 onwards, for post-interventional pneumothorax from 1960 onwards. Evidence levels according to the Oxford Center for Evidence-Based Medicine (2011) were assigned to the relevant studies found. Recommendations according to grade (A: "we recommend"/"we do not recommend," B: "we suggest"/"we do not suggest") were determined in 3 consensus conferences by the nominal group process. RESULTS: The algorithms for primary and secondary pneumothorax differ in the indication for CT scan as well as in the indication for chest drainage application and video-assisted thoracic surgery. Indication for surgery is recommended individually taking into account the risk of recurrence, life circumstances, patient preferences, and procedure risks. For some forms of secondary pneumothorax, a reserved indication for surgery is recommended. Therapy of post-interventional spontaneous pneumothorax is similar to that of primary spontaneous pneumothorax. DISCUSSION: The recommendations of the S3 Guideline provide assistance in managing spontaneous pneumothorax and post-interventional pneumothorax. Whether this will affect existing deviant diagnostic and therapeutic measures will be demonstrated by future epidemiological studies.
In Germany, 10,000 cases of spontaneous pneumothorax are treated inpatient every year. The German Society for Thoracic Surgery, in co-operation with the German Society for Pulmonology, the German Radiological Society, and the German Society of Internal Medicine has developed an S3 guideline on spontaneous pneumothorax and post-interventional pneumothorax moderated by the German Association of Scientific Medical Societies. METHOD: Based on the source guideline of the British Thoracic Society (2010) for spontaneous pneumothorax, a literature search on spontaneous pneumothorax was carried out from 2008 onwards, for post-interventional pneumothorax from 1960 onwards. Evidence levels according to the Oxford Center for Evidence-Based Medicine (2011) were assigned to the relevant studies found. Recommendations according to grade (A: "we recommend"/"we do not recommend," B: "we suggest"/"we do not suggest") were determined in 3 consensus conferences by the nominal group process. RESULTS: The algorithms for primary and secondary pneumothorax differ in the indication for CT scan as well as in the indication for chest drainage application and video-assisted thoracic surgery. Indication for surgery is recommended individually taking into account the risk of recurrence, life circumstances, patient preferences, and procedure risks. For some forms of secondary pneumothorax, a reserved indication for surgery is recommended. Therapy of post-interventional spontaneous pneumothorax is similar to that of primary spontaneous pneumothorax. DISCUSSION: The recommendations of the S3 Guideline provide assistance in managing spontaneous pneumothorax and post-interventional pneumothorax. Whether this will affect existing deviant diagnostic and therapeutic measures will be demonstrated by future epidemiological studies.
Authors: Sungjoon Park; Hyo Jun Jang; Ju Hoon Song; So Young Bae; Hyuck Kim; Seung Hyuk Nam; Jun Ho Lee Journal: Korean J Thorac Cardiovasc Surg Date: 2019-04-05
Authors: Stephan Eisenmann; Jane Winantea; Rüdiger Karpf-Wissel; Faustina Funke; Elena Stenzel; Christian Taube; Kaid Darwiche Journal: J Clin Med Date: 2020-05-15 Impact factor: 4.241