It is still uncertain if large-bore
chest tubes (20F-28F) is superior to pigtail
catheter (10F-14F) in terms of the management of secondary spontaneous pneumothoraces (SSP). This study was designed to compare the efficacy and safety associated with placement of large-bore
chest tubes vs pigtail
catheters in adults experiencing the first episode of SSP. We conducted a retrospective chart review of 91 patients experiencing the first episode of SSP in a university hospital over a 3.5-year period who received treatment by either a large-bore
chest tube or a pigtail
catheter. Any patient who was younger than 18 years or experiencing
mechanical ventilation-related
barotraumas or pyopneumothorax was excluded from this study. Various parameters including demographical characteristics, size of
pneumothorax, complications, time of pigtail or
chest tube extubation, and length of
hospital stay were collected and analyzed. Among the enrolled 91 patients, including 76 (83.5%) men with a mean age of 60 +/- 19 years, 69 were initially treated with a pigtail, and 22 patients received conventional
chest tubes. Fifty patients (72.5%) undergoing the pigtail drainage and 16 (72.7%) undergoing large-bore
chest tube treatment of SSP were successfully treated (P = .88). In addition, there was no significant difference in terms of length of
hospital stay, extubation time, recurrence rate, and complication. Pigtail
catheters offer a safe and effective alternative for large-bore
chest tubes to adult patients experiencing the first episode of SSP, and we strongly suggested that pigtail tube drainage should be considered as the initial treatment of choice.