TY - JOUR T1 - Simple aspiration versus intercostal tube drainage for primary spontaneous pneumothorax: A Cochrane review JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2015.PA1823 VL - 46 IS - suppl 59 SP - PA1823 AU - Brian Smith AU - Abel Wakai AU - Kristin Carson AU - Ronan O'Sullivan AU - Aileen McCabe Y1 - 2015/09/01 UR - http://erj.ersjournals.com/content/46/suppl_59/PA1823.abstract N2 - Background: Spontaneous pneumothorax (SP) management varies. Clinical effectiveness of simple aspiration compared to intercostal tube drainage needs to be systematically evaluated to produce evidence to underpin consistent best clinical practice.Aim: To compare the clinically efficacy, including hospital use and safety of, simple aspiration compared to intercostal tube drainage in the management of primary SP.Method: Two independent researchers screened Medline, CENTRAL, EMBASE, and other resources and bibliographies of randomised controlled studies, up until December 2014, in adults 18 years and older with primary SP. Data abstraction was conducted by two independent researchers.Results: Four studies from 1093 citations met the inclusion criteria (one ongoing). Immediate success rate of procedure (defined by study authors) and early failure rate of procedure (incomplete lung expansion after procedure) did not significantly differ between groups (risk ratio 0.85; 95%CI 0.69-1.06; 245 subjects) and (RR 1.24; 95%CI 0.87-1.75; 245 subjects) respectively. However, statistically significant benefits were observed in favour of aspiration for reducing hospitalisation (RR 0.44; 95%CI 0.34-0.57; p<0.00001; 245 subjects) and reducing length of stay (mean difference -1.61; 95%CI -2.40--0.81; p<0.0001; 197 subjects).Conclusion: Available studies found no significant difference in treatment efficacy between simple aspiration and intercostal tube drainage with respect to immediate success of procedure. However, aspiration was associated with reduced hospitalisation. Methodologically rigorous trials are needed to address outcomes including complications, patient satisfaction and cost. ER -