Does needle aspiration respond same in Primary and Secondary Spontaneous Pneumothorax?

Abstract

Objectives:To assess the effectiveness of percutaneous needle aspirations in the management of pneumothorax and compare its effectiveness in the treatment of primary spontaneous and secondary spontaneous pneumothorax. A secondary objective was to find the out come of patients in whom needle aspiration failed.Material and Methods:The study included all patients presenting with pneumothorax admitted to Chest unit from Jan 2002 to July 2003. Patients with tension pneumothorax, hydro-pneumothorax and recurrent pneumothorax were excluded from the study. It was a non-interventional descriptive study. The procedure was deemed successful if after aspiration, the lung expansion was normal or near normal.Results:During this period, 100 patients (60 males and 40 females) were studied. 30% (n=30) patients had PSP and 70% had SSP. The underlying cause of SSP was PTB in 57% (n=40) patients, COPD in 30% (n=21) and asthma in 13% (n=9) patients. Needle aspiration was successful in 54% patients and failed in 46%. Needle aspiration had good results in PSP (80%). In secondary pneumothorax it was successful in 43 % cases. The success rate of needle aspiration in pneumothorax due to COPD (62%) and Asthma (55%) was significantly better than pneumothorax due to PTB 30%.Conclusion:Needle aspiration can be used as a first line procedure in managing primary spontaneous pneumothorax. Its effectiveness in SSP due to asthma and COPD is comparable to that of PSP hence can be utilized as a first line procedure. The results are not as good in SSP with underlying diseased lung like Pulmonary TB.