Nederlandse longartsen lopen soms achter bij de moderne inzichten van de behandeling voor pneumothorax. In veel Nederlandse ziekenhuizen is het nog steeds gangbaar om een patiënt met een pneumothorax bij wie de long volledig of vrijwel volledig los ligt van de thoraxwand, te behandelen met een thoraxdrain. Is dat wel nodig?
In many Dutch hospitals, treatment of spontaneous pneumothorax (SP) routinely consists of in-hospital chest tube drainage. Alternatives, such as ambulatory Heimlich valves or manual aspiration of the pneumothorax, have become available in recent years. Neither treatment requires patient hospitalisation and pneumothorax recurrence rate is the same as after in-hospital treatment. A recent study demonstrated the same results for conservative treatment of SP (no intervention at all, outpatient-based) compared to chest tube drainage. In the future, treatment of SP should be outpatient-based as much as possible. As a rule, patients should only be hospitalised for prevention of recurrence using thoracoscopy and talc poudrage or video-assisted thoracoscopic surgery. Chest tube drainage should no longer be the first choice for the treatment of patients with SP.
Conflict of interest and financial support: none declared.