ROLE OF PERCUTANEOUS NEEDLE ASPIRATION IN THE MANAGEMENT OF PNEUMOTHORAX

Objective: To assess the effectiveness and safety of percutaneous needle aspirations in the management of pneumothorax and to see the difference in the outcome of needle aspirations as determined by size of pneumothorax.Material and Methods: The study included patients presenting with pneumothorax admitted to Chest unit from Jan 2002 to July 2003. Patients with tension pneumothorax, hydro-pneumothorax and recurrent pneumothorax were excluded from the study. It was a non-intervention descriptive study. The procedure was deemed successful if after aspiration, the lung expansion was normal or near normal.Results: During this period, 100 patients (60 males and 40 females) were studied. Needle aspiration was successful in 56% patients and failed in 44%. The impact of size of pneumothorax, on the success of needle aspirations was also studied. The success rate was 100% in 16 patients with small pneumothorax, 66% (.n=32) in 4S patients with moderate pneumothorax and 22% (n=8) in 36 patients in complete pneumothorax. The complications of needle aspiration included re-expansion pulmonary oedema in 3.5% (n=2), surgical emphysema in 3.5% (n=2) and recurrence of pneumothorax in 21% (n=12) patients. The total cost of equipment of needle aspiration was Rs. 100 versus Rs. 1500 for ICTD.Conclusion: Percutaneous needle aspiration is safe, effective and minimally invasive procedure. It can be used as a first line procedure in managing primary spontaneous pneumothorax. The outcome of the procedure is influenced by the size of pneumothorax; the smaller the pneumothorax better is the outcome of needle aspiration.