The influence of chest tube size and position in primary spontaneous pneumothorax

Background: Optimal chest tubeposition in the pleural cavityis largely unexplored for the treatment of primary spontaneous pneumothorax(PSP). We investigated whether type, size and position of chest tubesinfluenced duration of treatment for PSP. Methods: A retrospective follow-up study of all patients admitted with PSP over a 5-year period. Traumatic, iatrogenic and secondary pneumothoraxeswere excluded. Gender, age, smoking habits, type and size of chest tubeused ( pigtailcatheter or surgical chest tube) were recorded from the patients’ charts. All chest X-rays upon admittance and immediately following chest tubeplacement were retrieved and re-evaluated for size of pneumothorax(categorized into five groups) and location of the chest tubetip (categorized as upper, middle or lower third of the pleural cavity). All data were analysed in a Cox proportional hazards regression model. Results: We identified 134 patients with PSP. Baseline characteristics were similar for patients treated with surgical chest tubesand pigtailcatheters. Chest tubeduration was not significantly influenced by position of the chest tubetip, but was significantly longer in females (P Conclusions: Contrary to common belief and guidelines recommendation the position of a chest tubein the pleural cavitydid not significantly influence chest tubeduration, but it was significantly longer in patients who were treated with a surgical chest tube.