{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T03:19:02Z","timestamp":1793762342240,"version":"4.6.1"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003Primary spontaneous pneumothorax (PSP) and its high recurrence rate pose a therapeutic challenge to both patients and their managing surgeons. Mechanical or chemical pleurodesis can be used to prevent recurrence, but the optimal treatment often remains a matter of debate. This meta-analysis aims to compare the outcomes between mechanical and chemical pleurodesis following bullectomy for PSP.<\/jats:p><jats:p>\n          Materials and Methods\u2003Studies published up to 2019 were searched from Medline, Embase, Google Scholar, and Cochrane databases. A meta-analysis of randomized controlled trials (RCTs) and observational cohort studies (OCSs) comparing outcomes between mechanical and chemical pleurodesis for PSP was performed.<\/jats:p><jats:p>\n          Results\u2003Seven studies (one RCT and six OCSs) were included, comprising 1,032 cases of mechanical (799 abrasions, 202 pleurectomies, and 31 unspecified abrasions\/pleurectomies\/both), and 901 cases of chemical (643 talc, 69 minocycline, and 189 unspecified talc\/kaolin) pleurodesis. The recurrence rate of pneumothorax after chemical pleurodesis (1.2%) was significantly lower than mechanical pleurodesis (4.0%) (pooled odds ratio [OR]\u2009=\u20093.00; 95% confidence interval [CI]\u2009=\u20091.59\u20135.67; p\u2009=\u20090.0007; I\n          2\u2009=\u200919%). Hospital stay was also slightly shorter in the chemical pleurodesis group (pooled mean difference [MD]\u2009=\u20090.42 days; 95% CI\u2009=\u20090.12\u20130.72; p\u2009=\u20090.005; I\n          2\u2009=\u20090%). There was no statistically significant difference in postoperative complications (pooled OR\u2009=\u20091.18; 95%CI\u2009=\u20090.40\u20133.48; p\u2009=\u20090.76; I\n          2\u2009=\u200971%) and operative time (pooled MD\u2009=\u20093.50; 95%CI\u2009=\u2009\u22127.28 to 14.28; p\u2009=\u20090.52; I\n          2\u2009=\u200999%) between these two groups.<\/jats:p><jats:p>\n          Conclusion\u2003Chemical pleurodesis is superior to mechanical pleurodesis following bullectomy for PSP in reducing hospital stay and recurrence rate. However, more RCTs with longer follow-up are necessary to demonstrate the benefit of chemical pleurodesis for PSP.<\/jats:p>","DOI":"10.1055\/s-0039-1697959","type":"journal-article","created":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T23:06:46Z","timestamp":1570748806000},"page":"490-496","source":"Crossref","is-referenced-by-count":22,"title":["Mechanical versus Chemical Pleurodesis after Bullectomy for Primary Spontaneous Pneumothorax: A Systemic Review and Meta-Analysis"],"prefix":"10.1055","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5483-8381","authenticated-orcid":false,"given":"Sarah Kher Ru","family":"Sim","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Singapore General Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shireen Anne","family":"Nah","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amos Hong Pheng","family":"Loh","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin Yin","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2019,10,10]]},"reference":[{"issue":"06","key":"ref1","first-page":"1379","article-title":"Incidence of spontaneous pneumothorax in Olmsted County, Minnesota: 1950 to 1974","volume":"120","author":"L J Melton III","year":"1979","journal-title":"Am Rev Respir Dis"},{"issue":"117","key":"ref2","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1183\/09059180.00005310","article-title":"Spontaneous pneumothorax: epidemiology, pathophysiology and cause","volume":"19","author":"M Noppen","year":"2010","journal-title":"Eur Respir Rev"},{"issue":"S 02","key":"ref3","first-page":"ii18","article-title":"Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010","volume":"65","author":"A MacDuff","year":"2010","journal-title":"Thorax"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1378\/chest.119.2.590","article-title":"Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement","volume":"119","author":"M H Baumann","year":"2001","journal-title":"Chest"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1016\/S0022-5223(95)70203-2","article-title":"Safety and efficacy of video-assisted thoracic surgical techniques for the treatment of spontaneous pneumothorax","volume":"109","author":"K S Naunheim","year":"1995","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1097\/00019509-199706000-00012","article-title":"Video assisted thoracoscopic management of primary spontaneous pneumothorax","volume":"7","author":"A P Yim","year":"1997","journal-title":"Surg Laparosc Endosc"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1016\/S0003-4975(02)04816-6","article-title":"Video-assisted thoracic surgical treatment of initial spontaneous pneumothorax in young patients","volume":"76","author":"M Margolis","year":"2003","journal-title":"Ann Thorac Surg"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/S0003-4975(98)00621-3","article-title":"Minimally invasive management for first and recurrent pneumothorax","volume":"66","author":"G Massard","year":"1998","journal-title":"Ann Thorac Surg"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/S0140-6736(07)61163-5","article-title":"Recurrence rates of video-assisted thoracoscopic versus open surgery in the prevention of recurrent pneumothoraces: a systematic review of randomised and non-randomised trials","volume":"370","author":"A Barker","year":"2007","journal-title":"Lancet"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1510\/icvts.2008.176081","article-title":"Does video-assisted thoracoscopic pleurectomy result in better outcomes than open pleurectomy for primary spontaneous pneumothorax?","volume":"7","author":"H A Vohra","year":"2008","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"12","key":"ref11","doi-asserted-by":"crossref","first-page":"2151","DOI":"10.1016\/j.jpedsurg.2008.08.041","article-title":"Video-assisted thoracic surgery for primary spontaneous pneumothorax in children: is there an optimal technique?","volume":"43","author":"R C Bialas","year":"2008","journal-title":"J Pediatr Surg"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/S0003-4975(99)01299-0","article-title":"Videothoracoscopic treatment of primary spontaneous pneumothorax: a 6-year experience","volume":"69","author":"G Cardillo","year":"2000","journal-title":"Ann Thorac Surg"},{"issue":"05","key":"ref13","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1510\/icvts.2011.270280","article-title":"Mechanical versus chemical pleurodesis for management of primary spontaneous pneumothorax evaluated with thoracic echography","volume":"13","author":"H D Alayouty","year":"2011","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1093\/icvts\/ivs027","article-title":"Comparative study of talc poudrage versus pleural abrasion for the treatment of primary spontaneous pneumothorax","volume":"15","author":"S Moreno-Merino","year":"2012","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.ejcts.2010.10.012","article-title":"Video-assisted thoracoscopic surgery management of spontaneous pneumothorax--long-term results","volume":"40","author":"K Shaikhrezai","year":"2011","journal-title":"Eur J Cardiothorac Surg"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.4081\/cdr.2011.e9","article-title":"Video-assisted thoracoscopic surgery for the treatment of primary pneumothorax: talc pleurodesis or pleural abrasion? Retrospective multicentre study","volume":"1","author":"J Zabaleta","year":"2011","journal-title":"Chest Dis Reports"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.ejcdt.2015.12.010","article-title":"Pleurodesis: which of which in management of recurrent primary spontaneous pneumothorax","volume":"66","author":"E Kasem","year":"2017","journal-title":"Egypt J Chest Dis Tuberc"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.amjsurg.2014.06.009","article-title":"Management of the pediatric spontaneous pneumothorax: is primary surgery the treatment of choice?","volume":"208","author":"M E Lopez","year":"2014","journal-title":"Am J Surg"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1093\/icvts\/ivr094","article-title":"Does mechanical pleurodesis result in better outcomes than chemical pleurodesis for recurrent primary spontaneous pneumothorax?","volume":"14","author":"A H Sepehripour","year":"2012","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"03","key":"ref20","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1097\/SLA.0b013e31824723f4","article-title":"Thoracoscopic pleurodesis for primary spontaneous pneumothorax with high recurrence risk: a prospective randomized trial","volume":"255","author":"J-S Chen","year":"2012","journal-title":"Ann Surg"},{"issue":"05","key":"ref21","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1164\/rccm.200509-1414OC","article-title":"Additional minocycline pleurodesis after thoracoscopic surgery for primary spontaneous pneumothorax","volume":"173","author":"J-S Chen","year":"2006","journal-title":"Am J Respir Crit Care Med"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1183\/09031936.02.00278202","article-title":"Talcage by medical thoracoscopy for primary spontaneous pneumothorax is more cost-effective than drainage: a randomised study","volume":"20","author":"J M Tschopp","year":"2002","journal-title":"Eur Respir J"},{"issue":"05","key":"ref23","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1016\/j.athoracsur.2014.06.034","article-title":"Mechanical pleurodesis does not reduce recurrence of spontaneous pneumothorax: a randomized trial","volume":"98","author":"X Min","year":"2014","journal-title":"Ann Thorac Surg"},{"issue":"02","key":"ref24","doi-asserted-by":"crossref","first-page":"284","DOI":"10.3346\/jkms.2008.23.2.284","article-title":"Effects of additional pleurodesis with dextrose and talc-dextrose solution after video assisted thoracoscopic procedures for primary spontaneous pneumothorax","volume":"23","author":"W J Chung","year":"2008","journal-title":"J Korean Med Sci"},{"issue":"06","key":"ref25","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1183\/09031936.98.12061419","article-title":"Talc-induced inflammation in the pleural cavity","volume":"12","author":"M M van den Heuvel","year":"1998","journal-title":"Eur Respir J"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/S0140-6736(05)64860-X","article-title":"Respiratory failure due to insufflated talc","volume":"349","author":"J R Campos","year":"1997","journal-title":"Lancet"},{"issue":"04","key":"ref27","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1183\/09031936.00189710","article-title":"Short-term safety of thoracoscopic talc pleurodesis for recurrent primary spontaneous pneumothorax: a prospective European multicentre study","volume":"38","author":"P O Bridevaux","year":"2011","journal-title":"Eur Respir J"},{"issue":"02","key":"ref28","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1089\/lap.2009.0070","article-title":"Primary spontaneous pneumothorax in pediatric patients: our 7-year experience","volume":"20","author":"M \u017dganjer","year":"2010","journal-title":"J Laparoendosc Adv Surg Tech A"}],"container-title":["European Journal of Pediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0039-1697959.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,16]],"date-time":"2020-11-16T23:34:31Z","timestamp":1605569671000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0039-1697959"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,10]]},"references-count":28,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2020,11,16]]},"published-print":{"date-parts":[[2020,12]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0039-1697959","relation":{},"ISSN":["0939-7248","1439-359X"],"issn-type":[{"value":"0939-7248","type":"print"},{"value":"1439-359X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,10]]}}}