Chest Tube Bukan Terapi Lini Pertama pada Pneumotoraks Spontan Primer

Oleh :

dr. Sonny Seputra, Sp.B, M.Ked.Klin, FINACS

Berbagai studi telah membuktikan bahwa pemasangan chest tube atau selang dada interkostal bukan lagi merupakan terapi lini pertama pada pneumotoraks spontan primer (PSP). Selama beberapa dekade, manajemen pneumotoraks sering diperdebatkan dan rekomendasi antara berbagai pedoman saling kontradiktif.[1,2]

Sekilas tentang Pneumotoraks Spontan Primer

Pneumotoraks spontan dibagi menjadi pneumotoraks spontan primer dan sekunder. Pneumotoraks spontan primer atau primary spontaneous pneumothorax sering ditemukan pada orang sehat tanpa penyakit paru yang mendasari, sedangkan pneumotoraks spontan sekunder umumnya terjadi pada pasien yang mempunyai penyakit paru.

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Referensi

1. Filosso PL, Guerrera F, Sandri A, Roffinella M, Solidoro P, Ruffini E, Oliaro A. Errors and Complications in Chest Tube Placement. Thorac Surg Clin. 2017 Feb;27(1):57-67. doi: 10.1016/j.thorsurg.2016.08.009. PMID: 27865328.
2. MacDuff A, Arnold A, Harvey J; BTS Pleural Disease Guideline Group. Management of spontaneous pneumothorax: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010 Aug;65 Suppl 2:ii18-31.
3. Thelle A, Gjerdevik M, SueChu M, et al. Randomised comparison of needle aspiration and chest tube drainage in spontaneous pneumothorax. Eur Respir J 2017; 49: 1601296.
4. Lee JH, Kim R, Park CM. Chest Tube Drainage Versus Conservative Management as the Initial Treatment of Primary Spontaneous Pneumothorax: A Systematic Review and Meta-Analysis. J Clin Med. 2020 Oct 27;9(11):3456.
5. Brown SGA, Ball EL, Perrin K, Asha SE, Braithwaite I, Egerton-Warburton D, Jones PG, Keijzers G, Kinnear FB, Kwan BCH, Lam KV, Lee YCG, Nowitz M, Read CA, Simpson G, Smith JA, Summers QA, Weatherall M, Beasley R; PSP Investigators. Conservative versus Interventional Treatment for Spontaneous Pneumothorax. N Engl J Med. 2020 Jan 30;382(5):405-415.
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7. Zhu P, Xia H, Sun Z, Zhu D, Deng L, Zhang Y, Zhang H, Wang D. Manual aspiration versus chest tube drainage in primary spontaneous pneumothorax without underlying lung diseases: a meta-analysis of randomized controlled trials. Interact Cardiovasc Thorac Surg. 2019 Jun 1;28(6):936-944.
8. Wakai A, O'Sullivan RG, McCabe G. Simple aspiration versus intercostal tube drainage for primary spontaneous pneumothorax in adults. Cochrane Database Syst Rev. 2017 Sep 07;9:CD004479.
9. Baumann MH, Strange C, Heffner JE, Light R, Kirby TJ, Klein J, Luketich JD, Panacek EA, Sahn SA; AACP Pneumothorax Consensus Group. Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest. 2001 Feb;119(2):590-602.
10. Tschopp JM, Bintcliffe O, Astoul P, Canalis E, Driesen P, Janssen J, Krasnik M, Maskell N, Van Schil P, Tonia T, Waller DA, Marquette CH, Cardillo G. ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax. Eur Respir J. 2015 Aug;46(2):321-35.
11. Tschopp J-M, Marquette C-H. Spontaneous pneumothorax: stop chest tube as first-line therapy. European Respiratory Journal 2017 49: 1700306.

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