Joh, Hyon Keun
(Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine)
,
Moon, Duk Hwan
(Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine)
,
Lee, Sungsoo
(Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine)
Background: Primary spontaneous pneumothorax is commonly treated with chest tube insertion, which requires hospitalization. In this study, we evaluated the efficacy, costs, and benefits of a portable small-bore chest tube (Thoracic Egg; Sumitomo Bakelite Co. Ltd., Tokyo, Japan) compared with a conve...
Background: Primary spontaneous pneumothorax is commonly treated with chest tube insertion, which requires hospitalization. In this study, we evaluated the efficacy, costs, and benefits of a portable small-bore chest tube (Thoracic Egg; Sumitomo Bakelite Co. Ltd., Tokyo, Japan) compared with a conventional chest tube. Methods: We retrospectively analyzed all primary spontaneous pneumothorax patients who underwent treatment at Gangnam Severance Hospital between August 2014 and May 2018. Results: A total of 279 patients were divided into 2 groups: the conventional group (n=236) and the Thoracic Egg group (n=43). Of the 236 patients in the conventional group, 100 were excluded because they underwent surgery during the study period. The efficacy and cost were compared between the 2 groups. There was no statistically significant difference between the groups regarding recurrence (conventional group, 36 patients [26.5%]; Thoracic Egg group, 15 patients [29.4%]; p=0.287). However, the Egg group had statistically significantly lower mean medical expenses than the conventional group (433,413 Korean won and 522,146 Korean won, respectively; p<0.001). Conclusion: Although portable small-bore chest tubes may not be significantly more efficacious than conventional chest tubes, their use is significantly less expensive. We believe that the Thoracic Egg catheter could be a less costly alternative to conventional chest tube insertion.
Background: Primary spontaneous pneumothorax is commonly treated with chest tube insertion, which requires hospitalization. In this study, we evaluated the efficacy, costs, and benefits of a portable small-bore chest tube (Thoracic Egg; Sumitomo Bakelite Co. Ltd., Tokyo, Japan) compared with a conventional chest tube. Methods: We retrospectively analyzed all primary spontaneous pneumothorax patients who underwent treatment at Gangnam Severance Hospital between August 2014 and May 2018. Results: A total of 279 patients were divided into 2 groups: the conventional group (n=236) and the Thoracic Egg group (n=43). Of the 236 patients in the conventional group, 100 were excluded because they underwent surgery during the study period. The efficacy and cost were compared between the 2 groups. There was no statistically significant difference between the groups regarding recurrence (conventional group, 36 patients [26.5%]; Thoracic Egg group, 15 patients [29.4%]; p=0.287). However, the Egg group had statistically significantly lower mean medical expenses than the conventional group (433,413 Korean won and 522,146 Korean won, respectively; p<0.001). Conclusion: Although portable small-bore chest tubes may not be significantly more efficacious than conventional chest tubes, their use is significantly less expensive. We believe that the Thoracic Egg catheter could be a less costly alternative to conventional chest tube insertion.
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제안 방법
The patients made this decision after they were provided with careful explanations of the advantages and disadvantages of each method. Based on their choice, patients were divided into either the CCT group or the TEC group for a comparative analysis. Patients with SSP, recurrent PSP, signs of pleural effusion or hemothorax on chest X-rays, or hemodynamic instability were excluded from the present study.
In this retrospective study, which took place after the introduction of the Thoracic Egg catheter (TEC) in Korea, we analyzed the medical records of all patients who visited the emergency department or the outpatient clinic of the thoracic surgery department and were diagnosed with first-time PSP between August 2014 and May 2018. These patients were given the choice between CCT insertion with hospitalization and TEC insertion via a portable small-bore chest tube without hospitalization.
Patients with SSP, recurrent PSP, signs of pleural effusion or hemothorax on chest X-rays, or hemodynamic instability were excluded from the present study. Medical records, including patient characteristics and outpatient records and images, were reviewed and analyzed. This study was reviewed and approved by the Institutional Ethics Committee and Review Board of Gangnam Severance Hospital (IRB approval no.
After pleural puncture, the needle was removed from the catheter, and the catheter was inserted into the thoracic cavity, which was then fixed to the chest wall and connected to a plastic chamber using adhesive tape. Thirty minutes to 1 hour after Thoracic Egg insertion, a chest X-ray examination was performed. Patients were discharged after (1) confirmation of the position of the catheter in the thoracic cavity, (2) resolution of symptoms, and (3) confirmation of lung expansion.
대상 데이터
In this study, a total of 279 patients were included for analysis: 236 patients in the CCT group and 43 patients in the TEC group. The mean follow-up duration was 24.
데이터처리
Descriptive statistics were used to compare the variables between the 2 groups, using the chi-square test or the Fisher exact test for categorical variables and the Student t-test for continuous variables. All statistical analyses were performed using IBM SPSS ver.
성능/효과
In conclusion, in this study, we found that a portable small-bore chest tube may not be significantly more efficacious than a CCT. However, given that CCT usage normally requires hospitalization, while use of a portable small-bore chest tube does not, the latter produces significantly lower medical expenses.
참고문헌 (9)
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