La punción-aspiración es una técnica segura y eficaz en el tratamiento del neumotórax espontáneo primario

espanolObjetivo: Demostrar la eficacia y seguridad de la tecnica de puncion-aspiracion (PA) en el tratamiento del neumotorax espontaneo primario (NEP). Metodo: Estudio retrospectivo basado en una base de datos prospectiva de pacientes con neumotorax espontaneo primario que acudieron al servicio de urgencias (10 anos). Se compara a los pacientes en los que se ha realizado la puncion-aspiracion (PA) frente a los que no. Ademas, se compara en terminos de recidivas, reingresos, necesidad de cirugia o complicaciones, el grupo con un manejo ambulatorio frente al grupo de manejo hospitalario, y se analizan las variables asociadas al exito de la tecnica. Resultados: Se observan caracteristicas similares en cuanto a las variables descriptivas (sexo, lado del neumotorax, habito tabaquico, volumen aspirado) entre los dos grupos. La PA parece ser un factor protector en cuanto a la necesidad de ingreso con una OR 0,7 (IC95: 0,62-0,78). No se observan diferencias significativas en cuanto a recidivas, reingresos o necesidad de intervencion quirurgica. Ninguna variable descriptiva ha mostrado relacion con el exito o fracaso de la tecnica. La incidencia de complicaciones con dicha tecnica ha sido del 2,4%. Conclusiones: La tecnica de PA es segura y eficaz como primer escalon en el tratamiento del NEP y reduce los ingresos hospitalarios sin aumentar el riesgo de reingreso o recidiva. EnglishObjective: Our main aim was to demonstrate the efficacy and safety of needle aspiration for treating primary spontaneous pneumothorax. Methods: Retrospective study of data collected prospectively for patients who came to the emergency department with primary spontaneous pneumothorax over a 10-year period. We compared patients who underwent needle aspiration to those who did not. Patients who were hospitalized were compared to those managed as outpatients in terms of recurrences, readmissions, need for surgery, and complications. Variables that might be related to the success of the procedure were explored. Results: Patients who underwent needle aspiration were similar to those who did not with respect to sex, side affected, and pneumothorax size (volume), and smoking status. Needle aspiration seems to be a protective factor against hospitalization (odds ratio, 0.7; 95% CI, 0.62-0.78). No significant between-group differences were detected with respect to recurrence, readmission, or need for surgery. None of the descriptive variables were related to success or failure of needle aspiration. The incidence of complications of needle aspiration was 2.4% Conclusions: Needle aspiration is a safe, effective first-line treatment for primary spontaneous pneumothorax and does not increase risk for readmission or recurrence.