Primary spontaneous pneumothorax: does size matter?

There is increasing evidence supporting conservative management for patients with primary spontaneous pneumothorax (PSP) regardless of size [1, 2] which is reflected in the recent British Thoracic Society Guideline [3]. However, the size of the pneumothorax on radiograph likely still has an important influence on management decisions, as illustrated by a recent interactive clinical decision debate [4]. The studies showing non-inferiority in terms of re-expansion and more favorable patient-centered and safety outcomes for the conservative approach included a range of PSP sizes from medium to complete. Clinicians will benefit from understanding if efficacy and safety outcomes of conservative management are dependent on pneumothorax size. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of Interest: All authors have nothing to disclose.