Recommendations of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR)
Guidelines for the Diagnosis and Treatment of Spontaneous Pneumothorax
Juan J. Rivas de Andrésa,
, Marcelo F. Jiménez Lópezb, Laureano Molins López-Rodóc, Alfonso Pérez Trullénd, Juan Torres Lanzase
Corresponding author
jjrivas@jet.es
Correspondence: Dr. J.J. Rivas Servicio de Cirugía Torácica de Aragón Hospital Universitario Miguel Servet Paseo de Isabel la Católica, 1-3 50009 Zaragoza, Spain Correo electrónico
Correspondence: Dr. J.J. Rivas Servicio de Cirugía Torácica de Aragón Hospital Universitario Miguel Servet Paseo de Isabel la Católica, 1-3 50009 Zaragoza, Spain Correo electrónico
a Servicio de Cirugía Torácica de Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain
b Servicio de Cirugía Torácica, Hospital Universitario, Salamanca, Spain
c Servicio de Cirugía Torácica, Hospital Universitari Sagrat Cor, Barcelona, Spain
d Servicio de Neumología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
e Servicio de Cirugía Torácica, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
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Rivas de Andrés, Marcelo F. Jiménez López, Laureano Molins López-Rodó, Alfonso Pérez Trullén, Juan Torres Lanzas" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Juan J." "apellidos" => "Rivas de Andrés" "email" => array:1 [ 0 => "jjrivas@jet.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Marcelo F." 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Rivas Servicio de Cirugía Torácica de Aragón Hospital Universitario Miguel Servet Paseo de Isabel la Católica, 1-3 50009 Zaragoza, Spain Correo electrónico" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-10-02" "fechaAceptado" => "2008-01-30" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155358" "palabras" => array:6 [ 0 => "Spontaneous pneumothorax" 1 => "Bullae" 2 => "simple aspiration" 3 => "Chest drainage" 4 => "Video-assisted thoracoscopy" 5 => "Treatment" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155359" "palabras" => array:6 [ 0 => "Neumotórax espontáneo" 1 => "Bullas" 2 => "Aspiración simple" 3 => "Drenaje torácico" 4 => "Videotoracoscopia" 5 => "Tratamiento" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">This is the fourth update of the guidelines for the diagnosis and treatment of pneumothorax published by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR).</p><p class="elsevierStyleSimplePara elsevierViewall">Spontaneous pneumothorax, or the presence of air in the pleural space not caused by injury or medical intervention, is a significant clinical problem. We propose a method for classifying cases into 3 categories: partial, complete, and complete with total lung collapse. This classification, together with a clinical assessment, would provide sufficient information to enable physicians to decide on an approach to treatment.</p><p class="elsevierStyleSimplePara elsevierViewall">This update introduces simple aspiration in an outpatient setting as a treatment option that has yielded results comparable to conventional drainage in the management of uncomplicated primary spontaneous pneumothorax; this technique is not, as yet, widely used in Spain.</p><p class="elsevierStyleSimplePara elsevierViewall">For the definitive treatment of primary spontaneous pneumothorax, the technique most often used by thoracic surgeons is video-assisted thoracoscopic bullectomy and pleural abrasion.</p><p class="elsevierStyleSimplePara elsevierViewall">Hospitalization and conventional tube drainage is recommended for the treatment of secondary spontaneous pneumothorax.</p><p class="elsevierStyleSimplePara elsevierViewall">This update also has a new section on catamenial pneumothorax, a condition that is probably underdiagnosed.</p><p class="elsevierStyleSimplePara elsevierViewall">The definitive treatment for a recurring or persistent air leak is usually surgery or the application of talc through the drainage tube when surgery is contraindicated.</p><p class="elsevierStyleSimplePara elsevierViewall">Our aim in proposing treatment algorithms for the management of pneumothorax in these guidelines was to provide a useful tool for clinicians involved in the diagnosis and treatment of this disease.</p>" ] "es" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Se presenta la cuarta puesta al día de la “Normativa sobre diagnóstico y tratamiento del neumotórax”, de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR).</p><p class="elsevierStyleSimplePara elsevierViewall">La presencia de aire dentro de la cavidad pleural de causa no traumática o iatrógena es un problema clínico relevante. Se propone un método de cuantificación del neumotórax mediante su clasificación en parcial, completo o total, que junto a la valoración clínica parece suficiente para adoptar las diversas actitudes terapéuticas.</p><p class="elsevierStyleSimplePara elsevierViewall">En la presente actualización se incorpora la aspiración simple ambulatoria, como método equiparable en resultados al drenaje convencional, para el tratamiento del neumotórax espontáneo primario no complicado, cuyo uso no está todavía muy extendido en España.</p><p class="elsevierStyleSimplePara elsevierViewall">Para el tratamiento definitivo del neumotórax espontáneo primario, la cirugía videotoracoscópica con bullectomía y abrasión pleural es la técnica más ampliamente utilizada por la mayoría de cirujanos torácicos.</p><p class="elsevierStyleSimplePara elsevierViewall">En el tratamiento del neumotórax espontáneo secundario se recomienda el ingreso y la colocación de drenaje torácico convencional.</p><p class="elsevierStyleSimplePara elsevierViewall">Se ha introducido también una referencia al neumotórax catamenial, probablemente infradiagnosticado.</p><p class="elsevierStyleSimplePara elsevierViewall">En caso de recidiva o fuga aérea persistente, el tratamiento definitivo suele ser el quirúrgico o el uso de talco a través del drenaje en caso de contraindicación.</p><p class="elsevierStyleSimplePara elsevierViewall">Los algoritmos de estrategia terapéutica aquí propuestos pretenden convertirse en una herramienta de trabajo útil para todos los implicados en el diagnóstico y tratamiento de esta enfermedad.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:63 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of pneumothorax in England" "autores" => array:1 [ 0 => array:2 [ "etal" => 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| Year/Month | Html | Total | |
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| 2024 November | 8 | 7 | 15 |
| 2024 October | 92 | 61 | 153 |
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| 2024 April | 41 | 46 | 87 |
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| 2024 February | 34 | 28 | 62 |
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| 2023 March | 6 | 9 | 15 |
| 2023 February | 31 | 30 | 61 |
| 2023 January | 24 | 41 | 65 |
| 2022 December | 31 | 45 | 76 |
| 2022 November | 43 | 48 | 91 |
| 2022 October | 42 | 57 | 99 |
| 2022 September | 33 | 49 | 82 |
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| 2022 June | 47 | 55 | 102 |
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| 2021 February | 17 | 83 | 100 |
| 2021 January | 19 | 60 | 79 |
| 2020 December | 26 | 153 | 179 |
| 2020 November | 22 | 52 | 74 |
| 2020 October | 21 | 64 | 85 |
| 2020 September | 18 | 79 | 97 |
| 2020 August | 18 | 48 | 66 |
| 2020 July | 20 | 60 | 80 |
| 2020 June | 13 | 29 | 42 |
| 2020 May | 20 | 56 | 76 |
| 2020 April | 29 | 60 | 89 |
| 2020 March | 23 | 62 | 85 |
| 2020 February | 18 | 68 | 86 |
| 2020 January | 19 | 94 | 113 |
| 2019 December | 21 | 108 | 129 |
| 2019 November | 12 | 293 | 305 |
| 2019 October | 21 | 211 | 232 |
| 2019 September | 24 | 248 | 272 |
| 2019 August | 14 | 85 | 99 |
| 2019 July | 16 | 135 | 151 |
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| 2019 May | 29 | 184 | 213 |
| 2019 April | 26 | 146 | 172 |
| 2019 March | 21 | 116 | 137 |
| 2019 February | 21 | 72 | 93 |
| 2019 January | 22 | 91 | 113 |
| 2018 December | 31 | 149 | 180 |
| 2018 November | 40 | 188 | 228 |
| 2018 October | 38 | 144 | 182 |
| 2018 September | 23 | 121 | 144 |
| 2018 July | 0 | 1 | 1 |
| 2018 May | 5 | 4 | 9 |
| 2018 April | 14 | 37 | 51 |
| 2018 March | 6 | 50 | 56 |
| 2018 February | 7 | 28 | 35 |
| 2018 January | 15 | 25 | 40 |
| 2017 December | 5 | 117 | 122 |
| 2017 November | 4 | 309 | 313 |
| 2017 October | 9 | 393 | 402 |
| 2017 September | 9 | 318 | 327 |
| 2017 August | 8 | 327 | 335 |
| 2017 July | 14 | 278 | 292 |
| 2017 June | 28 | 292 | 320 |
| 2017 May | 24 | 298 | 322 |
| 2017 April | 20 | 279 | 299 |
| 2017 March | 25 | 345 | 370 |
| 2017 February | 10 | 300 | 310 |
| 2017 January | 8 | 252 | 260 |
| 2016 December | 12 | 156 | 168 |
| 2016 November | 18 | 155 | 173 |
| 2016 October | 25 | 88 | 113 |
| 2016 September | 38 | 54 | 92 |
| 2016 August | 37 | 17 | 54 |
| 2016 July | 20 | 16 | 36 |
| 2016 April | 2 | 0 | 2 |
| 2016 March | 2 | 0 | 2 |
| 2016 February | 2 | 0 | 2 |
| 2015 December | 2 | 0 | 2 |
| 2015 November | 6 | 12 | 18 |
| 2015 October | 1063 | 2 | 1065 |
| 2015 September | 1202 | 70 | 1272 |
| 2015 August | 1084 | 56 | 1140 |
| 2015 July | 1164 | 81 | 1245 |
| 2015 June | 923 | 48 | 971 |
| 2015 May | 1094 | 91 | 1185 |
| 2015 April | 1309 | 51 | 1360 |
| 2015 March | 1428 | 28 | 1456 |
| 2015 February | 1216 | 30 | 1246 |
| 2015 January | 1183 | 52 | 1235 |
| 2014 December | 1212 | 32 | 1244 |
| 2014 November | 1284 | 52 | 1336 |
| 2014 October | 1274 | 40 | 1314 |
| 2014 September | 787 | 42 | 829 |
| 2014 August | 927 | 52 | 979 |
| 2014 July | 895 | 26 | 921 |
| 2014 June | 733 | 31 | 764 |
| 2014 May | 723 | 39 | 762 |
| 2014 April | 605 | 32 | 637 |
| 2014 March | 564 | 31 | 595 |
| 2014 February | 513 | 38 | 551 |
| 2014 January | 487 | 24 | 511 |
| 2013 December | 347 | 36 | 383 |
| 2013 November | 233 | 32 | 265 |
| 2013 October | 404 | 27 | 431 |
| 2013 September | 269 | 32 | 301 |
| 2013 August | 231 | 36 | 267 |
| 2013 July | 219 | 37 | 256 |
| 2013 June | 152 | 27 | 179 |
| 2013 May | 165 | 26 | 191 |
| 2013 April | 128 | 22 | 150 |
| 2013 March | 27 | 4 | 31 |
Show all
