Conservative management of spontaneous pneumothorax.

In recent years many authors have advocated prompt active treatment for spontaneous pneumothorax in the belief that patients treated in this way recover more quickly and suffer fewer relapses (Lenox-Smith, 1962; Smith and Rothwell, 1962; Hamel, Briggs, and Schulkins, 1963). The material on which this attitude is based is very often related to hospital admissions only and does not reflect the overall experience of managing patients with pneumothorax as seen in outpatient departments and chest clinics, where many patients are supervised conservatively on an outpatient basis. Fearing that there was a risk of the radical treatment policy becoming established on too slender evideilce, we surveyed our cases of pneumothorax managed during a decade when there had been a constant policy aimed at keeping the patients at work whenever possible and certainly avoiding admission unless this was clearly necessary.