Treatment of spontaneous pneumothorax by mechanical pleurodesis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HUANG Dejing , ZONG Liang , ZHU Hui , ZHANG Haiping , SUN Qingchao , WANG Rui ,  ZHANG Zhu

Department of Thoracic Surgery, the First Affiliated Hospital of Xinjiang Medical University, Xinjiang Medical University, Urumqi, 830000, P.R.China;

Corresponding?author：

ZHANG Zhu, Email: zhangzhuxj@126.com

Keywords：

Video-assisted thoracoscopic surgery; pleurodesis; spontaneous pneumothorax; closed thoracic drainage

DOI：

10.7507/1007-4848.201607005

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the clinical efficacy of video-assisted thoracoscopic surgery (VATS) and pleurodesis for spontaneous pneumothorax. Methods A retrospective analysis of 157 patients with spontaneous pneumothorax undergoing VATS from January 2012 to March 2016 in our hospital was done. According to different treatments, patients were divided into two groups: a group A (65 patients receving pleurodesis, 52 males and 13 females with a mean age of 34.77 years ranging from 17 to 73 years) and a group B (92 patients without pleurodesis, 76 males and 16 females with a mean age of 34.66 years ranging from 16 to 72 years). In the group A 29 patients underwent closed thoracic drainage; while in the group B there were 39 patients. Results The patients were followed up for 3 months to 4 years. The recurrence rate of the group A was lower than that of the group B, but the difference was not statistically significant. For patients receving closed thoracic drainage preoperatively, intraoperative drainage volume at postoperative 24 h in the group A was more than that of the group B, but postoperative hospital stay was less than that of the group B (P<0.05). For patients not receving closed thoracic drainage preoperatively, drainage volume at postoperative 24 h, total drainage volume, postoperative hospital stay in the group A were more than those of the group B (P<0.05). Conclusion Pleurodesis can not reduce the recurrence rate of spontaneous pneumothorax. Preoperative closed thoracic drainage combined with intraoperative pleurodesis can effectively reduce postoperative hospitalization; therefore pleurodesis is recommended. If preoperative closed thoracic drainage is not adopted, surgery without pleurodesis can effectively reduce thoracic drainage at postoperative 24 h, total drainage volume and hospital stay and the perioperative results are better; therefore mechanical pleurodesis is not recommended.

Citation： HUANG Dejing, ZONG Liang, ZHU Hui, ZHANG Haiping, SUN Qingchao, WANG Rui, ZHANG Zhu. Treatment of spontaneous pneumothorax by mechanical pleurodesis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(12): 970-973. doi: 10.7507/1007-4848.201607005 Copy

1.	王新, 王雷. 單操作孔電視胸腔鏡手術治療原發性自發性氣胸. 中華腔鏡外科雜志: 電子版, 2012, 5(6): 45-47.
2.	王爭君, 徐亞歡, 張高峰, 等. 胸膜摩擦治療原發性自發性氣胸的再認識. 臨床肺科雜志, 2015, 20(12): 2190-2192.
3.	Haraguchi S, Koizumi K, Hioki M, et al. Postoperative recurrences of pneumothorax in video-assisted thoracoscopic surgery for primary spontaneous pneumothorax in young patients. J Nippon Med Sch, 2008, 75(2): 91-95.
4.	Tomasdottir GF, Torfason B, Isaksson HJ, et al. Comparison of video-assisted thoracoscopic surgery and limited axillary thoracotomy for spontaneous pneumothorax. Laeknabladid, 2007, 93(5): 405-412.
5.	Olavarrieta JR, Coronel P. Expectations and patient satisfaction related to the use of thoracotomy and video-assisted thoracoscopic surgery for treating recurrence of spontaneous primary pneumothorax. J Bras Pneumol, 2009, 35(2): 122-128.
6.	何江, 崔健, 金曉飛, 等. 24 例原發性自發性氣胸外科治療體會. 齊齊哈爾醫學院學報, 2016, 37(22): 2798-2799.
7.	Chen JS, Chan WK, Tsai KT, et al. Simple aspiration and drainage and intrapleural minocycline pleurodesis versus simple aspiration and drainage for the initial treatment of primary spontaneous pneumothorax: an open-label, parallel-group, prospective, randomised, controlled trial. Lancet, 2013, 381(9874): 1277-1282.
8.	Shaikhrezai K, Thompson AI, Parkin C, et al. Video-assisted thoracoscopic surgery management of spontaneous pneumothorax--long-term results. Eur J Cardiothorac Surg, 2011, 40(1): 120-3.
9.	王彬, 袁順達, 崔健. 兩孔法胸腔鏡手術處理肺大皰. 中國微創外科雜志, 2013, 13(4): 302-303.
10.	羅經文, 成俊玲, 陳開林, 等. 雙孔法電視胸腔鏡治療自發性氣胸. 中國微創外科雜志, 2011, 11(5): 454-455.
11.	Ramic N, Krdzalic G, Mesic D, et al. Video-assisted thoracoscopic surgery for spontaneous pneumothorax. Med Arh, 2010, 64(1): 22-24.
12.	李長青, 陶勇, 陳榮林, 等. 電視胸腔鏡治療自發性氣胸 62 例分析. 臨床肺科雜志, 2010, 15(12): 1758-1759.
13.	王文. 肺大泡切除后不同胸膜固定術對患者術后疼痛及生活質量的影響. 中國衛生產業, 2014, (28): 138-139.
14.	Sahn SA. Talc should be used for pleurodesis. Am J Respir Crit Care Med, 2001, 162(6): 2023-2024.
15.	Kennedy L, Sahn SA. Talc pleurodesis for the treatment of pneumothorax and pleural effusion. Chest, 1994, 106(4): 1215-1222.
16.	張源源, 戴佳鴻, 呂強聲, 等. 兩種胸膜固定術輔助治療肺大泡的臨床研究. 基層醫學論壇, 2014, (10): 1246-1248.
17.	Morimoto T, Shimbo T, Noguchi Y, et al. Effects of timing of thoracoscopic surgery for primary spontaneous pneumothorax on prognosis and costs. Am J Surg, 2004, 187(6): 767-774.
18.	孫威, 徐沁孜, 徐澄澄, 等. 電視胸腔鏡下治療無明顯肺大泡的自發性氣胸 39 例體會. 臨床外科雜志, 2011, 19(5): 334-335.
19.	呂英義, 張文峰, 李時捷, 等. 青年胸腔鏡肺大皰切除術后氣胸復發的原因分析. 中國醫師進修雜志, 2012, 35(20): 64-65.
20.	馮偉榮, 白曉鳴. 自發性氣胸研究進展. 實用醫技雜志, 2016, 23(1): 48-51.
21.	謝首智, 陳名久. 氣胸及肺術后漏氣的治療選擇與進展. 中國胸心血管外科臨床雜志, 2015, 22(6): 602-606.
22.	吳家會. 吹氣球呼吸訓練法在胸腔鏡治療自發性氣胸術后的應用探討. 重慶醫學, 2007, 36(24): 2546-2546.
23.	Chen JS, Hsu HH, Kuo SW, et al. Management of recurrent primary spontaneous pneumothorax after thoracoscopic surgery: should observation, drainage, redo thoracoscopy, or thoracotomy be used? Surg Endosc, 2009, 23(11): 2438-2444.
24.	成向陽, 熊信國, 陳漢章, 等. 自發性氣胸術后復發的治療及再次手術時機的選擇. 中華結核和呼吸雜志, 2007, 30(3): 170-172.
25.	Cardillo G, Facciolo F, Regal M, et al. Recurrences following videothoracoscopic treatment of primary spontaneous pneumothorax: the role of redo-videothoracoscopy. Eur J Cardiothorac Surg, 2001, 19(4): 396-399.

1. 王新, 王雷. 單操作孔電視胸腔鏡手術治療原發性自發性氣胸. 中華腔鏡外科雜志: 電子版, 2012, 5(6): 45-47.
2. 王爭君, 徐亞歡, 張高峰, 等. 胸膜摩擦治療原發性自發性氣胸的再認識. 臨床肺科雜志, 2015, 20(12): 2190-2192.
3. Haraguchi S, Koizumi K, Hioki M, et al. Postoperative recurrences of pneumothorax in video-assisted thoracoscopic surgery for primary spontaneous pneumothorax in young patients. J Nippon Med Sch, 2008, 75(2): 91-95.
4. Tomasdottir GF, Torfason B, Isaksson HJ, et al. Comparison of video-assisted thoracoscopic surgery and limited axillary thoracotomy for spontaneous pneumothorax. Laeknabladid, 2007, 93(5): 405-412.
5. Olavarrieta JR, Coronel P. Expectations and patient satisfaction related to the use of thoracotomy and video-assisted thoracoscopic surgery for treating recurrence of spontaneous primary pneumothorax. J Bras Pneumol, 2009, 35(2): 122-128.
6. 何江, 崔健, 金曉飛, 等. 24 例原發性自發性氣胸外科治療體會. 齊齊哈爾醫學院學報, 2016, 37(22): 2798-2799.
7. Chen JS, Chan WK, Tsai KT, et al. Simple aspiration and drainage and intrapleural minocycline pleurodesis versus simple aspiration and drainage for the initial treatment of primary spontaneous pneumothorax: an open-label, parallel-group, prospective, randomised, controlled trial. Lancet, 2013, 381(9874): 1277-1282.
8. Shaikhrezai K, Thompson AI, Parkin C, et al. Video-assisted thoracoscopic surgery management of spontaneous pneumothorax--long-term results. Eur J Cardiothorac Surg, 2011, 40(1): 120-3.
9. 王彬, 袁順達, 崔健. 兩孔法胸腔鏡手術處理肺大皰. 中國微創外科雜志, 2013, 13(4): 302-303.
10. 羅經文, 成俊玲, 陳開林, 等. 雙孔法電視胸腔鏡治療自發性氣胸. 中國微創外科雜志, 2011, 11(5): 454-455.
11. Ramic N, Krdzalic G, Mesic D, et al. Video-assisted thoracoscopic surgery for spontaneous pneumothorax. Med Arh, 2010, 64(1): 22-24.
12. 李長青, 陶勇, 陳榮林, 等. 電視胸腔鏡治療自發性氣胸 62 例分析. 臨床肺科雜志, 2010, 15(12): 1758-1759.
13. 王文. 肺大泡切除后不同胸膜固定術對患者術后疼痛及生活質量的影響. 中國衛生產業, 2014, (28): 138-139.
14. Sahn SA. Talc should be used for pleurodesis. Am J Respir Crit Care Med, 2001, 162(6): 2023-2024.
15. Kennedy L, Sahn SA. Talc pleurodesis for the treatment of pneumothorax and pleural effusion. Chest, 1994, 106(4): 1215-1222.
16. 張源源, 戴佳鴻, 呂強聲, 等. 兩種胸膜固定術輔助治療肺大泡的臨床研究. 基層醫學論壇, 2014, (10): 1246-1248.
17. Morimoto T, Shimbo T, Noguchi Y, et al. Effects of timing of thoracoscopic surgery for primary spontaneous pneumothorax on prognosis and costs. Am J Surg, 2004, 187(6): 767-774.
18. 孫威, 徐沁孜, 徐澄澄, 等. 電視胸腔鏡下治療無明顯肺大泡的自發性氣胸 39 例體會. 臨床外科雜志, 2011, 19(5): 334-335.
19. 呂英義, 張文峰, 李時捷, 等. 青年胸腔鏡肺大皰切除術后氣胸復發的原因分析. 中國醫師進修雜志, 2012, 35(20): 64-65.
20. 馮偉榮, 白曉鳴. 自發性氣胸研究進展. 實用醫技雜志, 2016, 23(1): 48-51.
21. 謝首智, 陳名久. 氣胸及肺術后漏氣的治療選擇與進展. 中國胸心血管外科臨床雜志, 2015, 22(6): 602-606.
22. 吳家會. 吹氣球呼吸訓練法在胸腔鏡治療自發性氣胸術后的應用探討. 重慶醫學, 2007, 36(24): 2546-2546.
23. Chen JS, Hsu HH, Kuo SW, et al. Management of recurrent primary spontaneous pneumothorax after thoracoscopic surgery: should observation, drainage, redo thoracoscopy, or thoracotomy be used? Surg Endosc, 2009, 23(11): 2438-2444.
24. 成向陽, 熊信國, 陳漢章, 等. 自發性氣胸術后復發的治療及再次手術時機的選擇. 中華結核和呼吸雜志, 2007, 30(3): 170-172.
25. Cardillo G, Facciolo F, Regal M, et al. Recurrences following videothoracoscopic treatment of primary spontaneous pneumothorax: the role of redo-videothoracoscopy. Eur J Cardiothorac Surg, 2001, 19(4): 396-399.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Treatment of spontaneous pneumothorax by mechanical pleurodesis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content