Chemical pleurodesis for prolonged postoperative air leak in primary spontaneous pneumothorax
Journal
Journal of the Formosan Medical Association
Journal Volume
113
Journal Issue
5
Pages
284-290
Date Issued
2014
Author(s)
Abstract
Background/Purpose: Prolonged air leak is the most common complication after thoracoscopic operation for primary spontaneous pneumothorax (PSP), and the role of chemical pleurodesis in treating air leaks remains unclear. This study evaluated the safetyand efficacy of chemical pleurodesis with a comparison between minocycline and OK-432. Methods: Between 1994 and 2011, 1083 PSP patients were treated by thoracoscopic operation. After the operation, patients with persistent air leak for 3 days or more were managed by minocycline or OK-432 pleurodesis. The demographic and outcome data for these patients were collected by retrospective chart review. Results: Seventy-nine patients (7.3%) with prolonged air leak after thoracoscopy underwent minocycline pleurodesis (60 patients) or OK-432 pleurodesis (19 patients) as the primary treatment. The primary success rate was 63% (38/60) for minocycline pleurodesis and 95% (18/19) for OK-432 pleurodesis ( p=0.009). Postpleurodesis pain was common and comparable between the two groups. No major complications were noted after a total of 121 treatments. Patients undergoing primary OK-432 pleurodesis had shorter durations of postpleurodesis chest drainage (mean 8.5 vs. 2.3 days; p<0.001) and postoperative hospital stay (mean 11.9 vs. 6.8 days; p<0.001) than those undergoing primary minocycline pleurodesis. After a median follow-up of 16 months, recurrence was noted in one patient in the OK-432 group and none in the minocycline group. Long-term pulmonary function in the two groups was comparable. Conclusion: Chemical pleurodesis using OK-432 or minocycline is safe and convenient for prolonged air leak after thoracoscopic treatment for PSP. Our experience suggested that OK-432 may be more effective than minocycline in reducing air leak. ? 2013.
SDGs
Other Subjects
minocycline; paracetamol; pethidine; picibanil; minocycline; picibanil; adult; article; chemical pleurodesis; clinical effectiveness; conservative treatment; controlled study; drug efficacy; drug fever; drug safety; female; follow up; human; length of stay; lung complication; lung function; major clinical study; male; medical record review; outcome assessment; pain; pleura effusion; pleurodesis; postoperative air leak; postoperative complication; postoperative pain; postoperative period; recurrent disease; retrospective study; spontaneous pneumothorax; thorax drainage; video assisted thoracoscopic surgery; adverse effects; pleurodesis; pneumothorax; Postoperative Complications; procedures; Adult; Female; Humans; Male; Minocycline; Picibanil; Pleurodesis; Pneumothorax; Postoperative Complications; Retrospective Studies; Thoracic Surgery, Video-Assisted
Publisher
Elsevier Ltd
Type
journal article