Efficacy of Blebs Detection for Preventive Surgery in Children’s Idiopathic Spontaneous Pneumothorax

• Published in: World journal of surgery Vol. 34; no. 1; pp. 185 - 189
• Main Authors: Nathan, Nadia, Guilbert, Julia, Larroquet, Michèle, Lenoir, Marion, Clement, Annick, Epaud, Ralph
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01-01-2010; Springer‐Verlag; Springer; Springer Nature B.V
• Subjects: Abdominal Surgery; Adolescent; Biological and medical sciences; Blister - diagnostic imaging; Blister - surgery; Cardiac Surgery; Chest Tube Drainage; Chi-Square Distribution; Child; Female; General aspects; General Surgery; Humans; Male; Medical sciences; Medicine; Medicine & Public Health; Pneumology; Pneumothorax; Pneumothorax - diagnostic imaging; Pneumothorax - prevention & control; Pneumothorax - surgery; Prevention and actions; Preventive Surgery; Primary Spontaneous Pneumothorax; Public health. Hygiene; Public health. Hygiene-occupational medicine; Recurrence; Recurrence Prevention; Respiratory system : syndromes and miscellaneous diseases; Retrospective Studies; Sensitivity and Specificity; Surgery; Thoracic Surgery; Thoracic Surgery, Video-Assisted; Tomography, X-Ray Computed; Vascular Surgery; Recurrence Prevention; Pneumothorax; Chest Tube Drainage; Preventive Surgery; Primary Spontaneous Pneumothorax; Human; Effusion; Respiratory disease; Treatment efficiency; Spontaneous; Idiopathic; Medicine; Prevention; Treatment; Surgery; Pleural disease; Diagnosis; Detection; Child
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-009-0286-x

Background
This retrospective, single-center study was designed to assess our management strategy based on blebs detection on the initial CT scan.
Methods
Children younger than aged 18 years presenting with a primary spontaneous pneumothorax (PSP) between 2000 and 2007 in a University Children’s Hospital (hospital Armand Trousseau, Paris, France) were included in this study.
Results
Twenty-five children who presented with PSP were included. The mean age was 14.2 ± 1.9 years, and the sex ratio was 2.1. There was no significant difference between patients with or without blebs with regard to the anthropomorphic data or the side of the pneumothorax. Six patients had recurrence, which, in most cases, was a grade 1 pneumothorax. Fourteen (56%) children showed blebs on CT scan, which was ipsilateral or bilateral in 13 cases and contralateral in 1 case. Eleven of these children had surgery, and all the remaining patients (
n
 = 3) had recurrence. All the patients, except one, presenting blebs on the preoperating CT scan, showed blebs on the subsequent surgery (predictive positive value = 92%), and the CT-scan sensibility for blebs was 75%.
Conclusions
In children, blebs detection on CT scan has a good sensitivity and may be a useful tool to determine the indication of lung surgery to prevent PSP recurrence.