Although the primary outcome was not statistically robust to conservative assumptions about missing data, the trial provides modest evidence that conservative management of primary spontaneous pneumothorax was noninferior to interventional management, with a lower risk of serious adverse events.

A total of 316 patients underwent randomization (154 patients to the intervention group and 162 to the conservative-management group).

In this open-label, multicenter, noninferiority trial, patients 14 to 50 years of age were recruited with a first-known, unilateral, moderate-to-large primary spontaneous pneumothorax.

In the conservative-management group, 25 patients (15.4%) underwent interventions to manage the pneumothorax, for reasons prespecified in the protocol, and 137 (84.6%) did not undergo interventions.

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