Chemical pleurodesis with Viscum album L. extract for secondary spontaneous pneumothorax in elderly patients

Kim, Jong Duk; Choi, Jae Won; Park, Hyun Oh; Lee, Chung Eun; Jang, Inseok; Choi, Jun Young; Kang, Dong Hoon; Jung, Jae Jun; Yang, Jun; Moon, Sung Ho; Byun, Joung Hun; Kim, Sung Hwan; Kim, Jong Woo

doi:10.21037/jtd-20-708

Cited by 4 publications

(4 citation statements)

References 32 publications

(52 reference statements)

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“…V. album , a European mistletoe, can act as sclerosant and it was previously proven effective to treat malignant pleural effusion and malignant ascites in many studies [ 10 ]. Viscum was also successfully used in chemical pleurodesis for secondary spontaneous pneumothorax in elderly patients [ 5 ]. V. album is known to be a considerably safe agent with mild adverse effects compared to other sclerotic agents, such as Picibanil (OK-432) which was used as a sclerosing agent in lymphatic malformation and in some cases of lymphoceles or intractable chylous leak after neck dissection [ 11 – 13 ].…”

Section: Discussionmentioning

confidence: 99%

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Alternative management of intractable chylous ascites following robot-assisted pancreaticoduodenectomy of <i>Viscum album</i> sclerotherapy: a case report

Kim¹,

Seo²,

Kang³

2022

Korean J Clin Oncol

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A patient showed signs of fever and Hemovac insertion site discharge 8 days after surgery and was admitted. Abdominal paracentesis found milky ascites with triglyceride levels of the peritoneal fluid as high as 1,603 g/mL. Diagnosed as chylous ascites, symptomatic therapy such as empirical antibodies and diuretics was administered with paracentesis before being discharged. The ascites volume increased again, and the patient was re-admitted. The patient was treated with orlistat, octreotide, total parenteral nutrition administration, ascites drainage, and diuretics. Ascites levels increased further and intraperitoneal Viscum was administered. Clear ascites was observed, and the patient was discharged. We reported a case where conventional treatment for chylous ascites that occurred after pancreaticoduodenectomy was shown to be ineffective while Viscum extracted from mistletoe was able to manage chylous ascites.

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Section: Discussionmentioning

confidence: 99%

“…V. album extract also acts as a sclerosant and it was proven to be effective in treating malignant pleural effusion in many studies [ 4 ]. It was also shown to be successful in the treatment of secondary spontaneous pneumothorax in elderly patients [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Alternative management of intractable chylous ascites following robot-assisted pancreaticoduodenectomy of <i>Viscum album</i> sclerotherapy: a case report

Kim¹,

Seo²,

Kang³

2022

Korean J Clin Oncol

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“…One of the most important issues in the treatment of PSP is preventing recurrence. Although surgery is the most effective treatment for PSP, the recurrence rate of pneumothorax remains 5-15% after thoracoscopic surgery [3][4][5][6]11,12 . In order to minimize recurrence rate of postoperative pneumothorax, chemical pleurodesis has been performed simultaneously with resection or sequentially.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Viscum Pleurodesis and Bullectomy in Patients With Primary Spontaneous Pneumothorax

Jung

Kim

2021

Preprint

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Objectives: Although surgery is the gold standard for treatment of primary spontaneous pneumothorax (PSP), recurrence after surgery remains a concern. This study sought to evaluate the efficacy of simultaneous pleurodesis using Viscum album (VA) extract and bullectomy for the treatment of PSP.Methods: From March 2016 to November 2020, 196 patients with PSP underwent bullectomy and intraoperative pleurodesis with VA extract at a single institution. All operations were performed through video-assisted thoracic surgery by one surgeon. Upon completion of bullectomy, a polyglycolic acid sheet was used to cover the stapler lines, and 40 mg of VA extract was instilled over the entire chest wall before chest tube placement.Results: The mean operating time was 18.5±5.0 minutes (range, 10–65) and the mean indwelling time of chest drainage was 1.8±0.5 days (range, 2–6). There were no postoperative complications over grade 3. During the median follow-up period of 36.3±18.4 months (range, 2–57), no recurrence of pneumothorax was observed.Conclusions: The results of this study demonstrated that simultaneous Viscum pleurodesis and bullectomy provides a feasible and effective treatment option for preventing postoperative pneumothorax in patients with PSP.

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“…Indications include postoperative air leaks, apical residual spaces or chylothorax after thoracic surgery, and persistent air leaks in patients with pneumothorax who are unsuitable for surgical treatment [1][2][3][4][5]. Pleurodesis agents vary widely, from autologous blood patches and 50% glucose solution to chemical agents such as talc, antibiotics, chemotherapy agents, Viscum album extract, iodopovidone, and OK-432 [2,4,[6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Early Pleurodesis for Postoperative Air Leak with Autologous Blood and 50% Glucose Solution

2022

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Background: Postoperative air leaks after pulmonary resection prolong the duration of chest drainage and the length of hospital stay. One of the many treatment options is bedside pleurodesis using various agents. This study evaluated the feasibility of an early intervention to stop postoperative air leaks with either autologous blood or a 50% glucose solution. Methods: We retrospectively reviewed 323 patients who underwent bedside pleurodesis between January 2017 and March 2022. Sixty-four patients received autologous blood patch pleurodesis, and 36 were treated with a 50% glucose solution after pulmonary resection. The primary endpoints were the total postoperative tube indwelling time, post-pleurodesis tube indwelling time, and hospital stay. A propensity score-matched analysis was performed. Results: In the autologous blood patch pleurodesis and 50% glucose solution groups, the mean initiation timing of postoperative pleurodesis were 2.06±1.62 and 3.28±1.56 days, the mean duration of the tube indwelling time after surgery was 6.58±3.02 and 6.42±4.92 days, and the mean duration of the tube indwelling time after pleurodesis, it was 4.53±3.10 and 3.11±4.80 days, respectively. In addition, the total length of hospital stay was 9.11±5.42 and 7.83±4.75 days in the autologous blood patch pleurodesis and 50% glucose solution groups, respectively. Conclusion: Early postoperative air leak cessation with autologous blood patch pleurodesis or 50% glucose solution pleurodesis is a feasible procedure with acceptable outcomes that effectively shortens the hospital stay.

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Chemical pleurodesis with Viscum album L. extract for secondary spontaneous pneumothorax in elderly patients

Cited by 4 publications

References 32 publications

Alternative management of intractable chylous ascites following robot-assisted pancreaticoduodenectomy of <i>Viscum album</i> sclerotherapy: a case report

Alternative management of intractable chylous ascites following robot-assisted pancreaticoduodenectomy of <i>Viscum album</i> sclerotherapy: a case report

Simultaneous Viscum Pleurodesis and Bullectomy in Patients With Primary Spontaneous Pneumothorax

Early Pleurodesis for Postoperative Air Leak with Autologous Blood and 50% Glucose Solution

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