Comparative Analysis of the Pleural Vent versus the Intercostal Tube for Managing Spontaneous Pneumothorax

Ahmed M Abdelazim; Ayman M Shaalan; Mahmoud M Abdel Azeem Mubarak

Ahmed M Abdelazim Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Ayman M Shaalan Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Mahmoud M Abdel Azeem Mubarak Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt

Keywords: Pleural vents, Spontaneous pneumothorax, Intercostal chest tubes

Abstract

Background: Evidence supporting using pleural venting over traditional intercostal chest drains for managing spontaneous pneumothorax is limited. Therefore, this study aimed to compare using pleural vents and intercostal tubes in managing spontaneous pneumothorax.

Methods: In this randomized clinical trial, 61 patients with spontaneous pneumothorax were randomly assigned to two groups. Group I included patients initially managed via intercostal chest tubes (n= 31), and Group II included patients with a pleural vent as the initial management (n= 30). The study outcomes were pain score; the need for nonsteroidal anti-inflammatory medications (NSAIDs) or narcotics; wound infections; pleural effusion; the duration of treatment; the need for surgery; and patient satisfaction and recurrence of pneumothorax at 1, 3, and 6 months after discharge.

Results: The baseline data were comparable between the groups, with no differences in the laterality or size of the pneumothorax. The requirements for NSAIDs (77% vs. 13%, p<0.001) and narcotics (42% vs. 0%, p<0.001) were more frequent in Group I. The duration of treatment was longer in Group 1 (3.71± 0.78 vs. 3.03± 0.61 days; p<0.001). Surgery was required more frequently in Group I (61% vs. 0%, p<0.001). Recurrence after three months was more common in Group I (11 (35.48%) vs. 1 (3.33%); p= 0.003). There was no difference in posttreatment pleural effusion between the groups, whereas wound infection was more common in Group I.

Conclusions: Pleural vents for managing spontaneous pneumothorax offer significant advantages over traditional intercostal chest tube placement. Patients managed with pleural vents experienced markedly lower pain levels, reduced reliance on NSAIDs and narcotics, and shorter treatment durations. Additionally, the need for surgical intervention and recurrence rates were substantially lower in the pleural vent group.