Simple Aspiration versus Drainage for Complete Pneumothorax: A Randomized Non-Inferiority Trial

Marx T, Joly LM, Parmentier AL, Pretalli JB, Puyraveau M, Meurice JC, Schmidt J, Tiffet O, Ferretti G, Lauque D, Honnart D, Al Freijat F, Dubart AE, Grandpierre RG, Viallon A, Perdu D, Roy PM, El Cadi T, Bronet N, Duncan G, Cardot G, Lestavel P, Mauny F, Desmettre T

Am J Respir Crit Care Med. 2023 Jun 1;207(11):1475-1485.

What is the key question?

  • To determine if simple aspiration (SA) as a first-line treatment for complete primary spontaneous pneumothorax (PSP) compared to chest tube drainage (CTD) in achieving satisfactory lung expansion

What is the bottom line?

  • Four-hundred patients were recruited between the two of this randomized non-inferiority study
  • Patients with SA had a higher treatment failure (29%) compared to CTD (18%) when comparing lung expansion as the primary end-point
  • SA was better tolerated than CTD with almost half the pain scores, and also had lesser equipment-related complications
  • Recurrence at 1-year was lower for SA (20%) compared to CTD (27%), and so was hospital days (mean 5.81 versus 7.6 days)

Why read on?

  • The authors detail the non-inferiority criteria used for comparing the two techniques and discuss the benefits of SA in PSP compared to CTD