Efficacy and Cost-Effectiveness of Portable Small-Bore Chest Tube (Thoracic Egg Catheter) in Spontaneous Pneumothorax

Background: Primary spontaneous pneumothorax is commonly treated with chest tube insertion, which requires hospitalization. In this study, we evaluated the efficacy, costs, and benefits of a portable small-bore chest tube (Thoracic Egg; Sumitomo Bakelite Co. Ltd., Tokyo, Japan) compared with a conventional chest tube. Methods: We retrospectively analyzed all primary spontaneous pneumothorax patients who underwent treatment at Gangnam Severance Hospital between August 2014 and May 2018. Results: A total of 279 patients were divided into 2 groups: the conventional group (n=236) and the Thoracic Egg group (n=43). Of the 236 patients in the conventional group, 100 were excluded because they underwent surgery during the study period. The efficacy and cost were compared between the 2 groups. There was no statistically significant difference between the groups regarding recurrence (conventional group, 36 patients [26.5%]; Thoracic Egg group, 15 patients [29.4%]; p=0.287). However, the Egg group had statistically significantly lower mean medical expenses than the conventional group (433,413 Korean won and 522,146 Korean won, respectively; p<0.001). Conclusion: Although portable small-bore chest tubes may not be significantly more efficacious than conventional chest tubes, their use is significantly less expensive. We believe that the Thoracic Egg catheter could be a less costly alternative to conventional chest tube insertion.