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 guidelines [3]. However, the size of the pneumothorax on the 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 favourable patient-centred 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.

越来越多的证据支持对原发性自发性气胸 (PSP) 患者进行保守治疗，无论其大小如何 [1, 2]，这在最近的英国胸科学会指南中得到了反映 [3]。然而，正如最近的交互式临床决策辩论所表明的那样，放射照片上气胸的大小可能仍然对管理决策具有重要影响[4]。研究表明保守方法在再扩张方面具有非劣效性，并且以患者为中心更有利，安全性结果包括从中等到完整的一系列 PSP 大小。了解保守治疗的有效性和安全性结果是否取决于气胸的大小，临床医生将受益匪浅。