{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:06:57Z","timestamp":1787846817683,"version":"build-2784847793"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Our aim was to explore the applicability of the definition of \u201clarge\u201d primary spontaneous pneumothorax (PSP) of adult guidelines to pediatric patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a retrospective monocentric analysis of first\u2010episodes of PSP (Period: January 2010\u2013January 2023). We defined large PSP according to French SPLF\/SMFU\/SRLF\/SFAR\/SFCTCV Guidelines. Inclusion criteria: age 1\u221218 years\u2010old, follow\u2010up\u2009\u2265\u20091 year. We performed a comparative analysis between large and nonlarge PSP. We reported the categorical variables as frequencies, and continuous as median and range. We compared categorical variables using Chi\u2010Square or Fisher test, and continuous using\n                      <jats:italic>U<\/jats:italic>\n                      Mann\u2013Whitney test.\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 was considered significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The population consisted of 49 patients, 15 (30%) with large PSP. We found no significant differences at presentation between large and nonlarge PSP regarding age, sex, side, BMI, oxygen saturation, respiratory rate and hearth rate. Conservative first\u2010line management was used significantly less for large PSP (26% vs. 82%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0003), while drain more (46% vs. 8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). The groups were similar regarding surgery. Large PSP had a significantly longer hospitalization (7 days vs. 4 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). The incidence of first\u2010line management failure was similar between the groups. During the follow\u2010up, we found no significant differences regarding ipsilateral recurrence (33% vs. 17%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.275), and contralateral occurrence (0% vs. 5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.000), need for drain (6% vs. 5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.000), or surgery (33% vs. 14%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.246).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the first\u2010line, large PSP were treated significantly less conservatively and more drained. Radiographic size of the pneumothorax does not seem to have an impact on first\u2010line treatment failure and follow\u2010up outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.27290","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T08:39:19Z","timestamp":1732696759000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["<i>LARGE<\/i>\n                    primary spontaneous pneumothorax (2023 French Guidelines definition): Do radiographic size matter in pediatric patients? A comparative analysis"],"prefix":"10.1002","volume":"60","author":[{"given":"Angelo","family":"Zarfati","sequence":"first","affiliation":[{"name":"General Pediatric Surgery Unit, Bambino Ges\u00f9 Children's Hospital IRCCS Rome Italy"},{"name":"University of \u201cTor Vergata\u201d Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7742-8838","authenticated-orcid":false,"given":"Giovanni","family":"Rollo","sequence":"additional","affiliation":[{"name":"General Pediatric Surgery Unit, Bambino Ges\u00f9 Children's Hospital IRCCS Rome Italy"},{"name":"University of \u201cTor Vergata\u201d Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4629-8132","authenticated-orcid":false,"given":"Simone","family":"Frediani","sequence":"additional","affiliation":[{"name":"General Pediatric Surgery Unit, Bambino Ges\u00f9 Children's Hospital IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Pardi","sequence":"additional","affiliation":[{"name":"General Pediatric Surgery Unit, Bambino Ges\u00f9 Children's Hospital IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan Pietro","family":"Aloi","sequence":"additional","affiliation":[{"name":"General Pediatric Surgery Unit, Bambino Ges\u00f9 Children's Hospital IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianna","family":"Bertocchini","sequence":"additional","affiliation":[{"name":"General Pediatric Surgery Unit, Bambino Ges\u00f9 Children's Hospital IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Accinni","sequence":"additional","affiliation":[{"name":"General Pediatric Surgery Unit, Bambino Ges\u00f9 Children's Hospital IRCCS Rome 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