Effectiveness of Thoracoscopic Talc Pleurodesis in the Management of Complicated Spontaneous Pneumothorax

Adewole, Olanisun Olufemi; Keukeleire, Tom De; Phillips, Abimbola; Erhabor, G E; Noppen, Marc

doi:10.1097/lbr.0000000000000134

Cited by 12 publications

(7 citation statements)

References 12 publications

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“… 19 Two case series, without comparators, estimated 10.2% recurrence in patients presenting with recurrent PSP or ongoing air leak (including early failures), 20 and 9.5% in combination of first episode (62%) and recurrent (38%) PSPs. 21 All four studies had follow-up periods of at least 24 months ( table 1 ).…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of chemical pleurodesis in spontaneous pneumothorax recurrence prevention: a systematic review

Hallifax

Yousuf

Jones

et al. 2016

Thorax

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ObjectivesSpontaneous pneumothorax is a common pathology. International guidelines suggest pleurodesis for non-resolving air leak or recurrence prevention at second occurrence. This study comprehensively reviews the existing literature regarding chemical pleurodesis efficacy.DesignWe systematically reviewed the literature to identify relevant randomised controlled trials (RCTs), case–control studies and case series. We described the findings of these studies and tabulated relative recurrence rates or ORs (in studies with control groups). Meta-analysis was not performed due to substantial clinical heterogeneity.ResultsOf 560 abstracts identified by our search strategy, 50 were included in our systematic review following screening. Recurrence rates in patients with chest tube drainage only were between 26.1% and 50.1%. Thoracoscopic talc poudrage (four studies (n=249)) provided recurrence rates of between 2.5% and 10.2% with the only RCT suggesting an OR of 0.10 compared with drainage alone. In comparison, talc administration during video-assisted thoracic surgery (VATS) from eight studies (n=2324) recurrence was between 0.0% and 3.2%, but the RCT did not demonstrate a significant difference compared with bleb/bullectomy alone. Minocycline appears similarly effective post-VATS (recurrence rates 0.0–2.9%). Prolonged air leak and recurrence prevention using tetracycline via chest drain (n=726) is likely to provide recurrence rates between 13.0% and 33.3% and autologous blood patch pleurodesis (n=270) between 15.6% and 18.2%.ConclusionsChemical pleurodesis postsurgical treatment or via thoracoscopy appears to be most effective. Evidence for definitive success rates of each agent is limited by the small number of randomised trials or other comparative studies.

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Section: Resultsmentioning

confidence: 99%

“… 18 19 However, more recent case series data suggested higher recurrence rates (9.5% 20 and 10.2%). 21 …”

Section: Discussionmentioning

confidence: 99%

Effectiveness of chemical pleurodesis in spontaneous pneumothorax recurrence prevention: a systematic review

Hallifax

Yousuf

Jones

et al. 2016

Thorax

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“…91,92 VATS is effective in achieving pleurodesis in a less invasive manner, unlike open thoracotomy. 99,100 A metaanalysis of trials over 20 years had initially suggested that a potential pneumothorax recurrence rate among VATS patients compared with those subjected to open thoracotomy, 101 but this may not be necessarily true as there is a steep learning curve in learning these surgical techniques. 102 Subsequent studies thereafter showed that VATS has similar pleurodesis success rates comparatively and also reduced postoperative pain and LOS.…”

Section: Pleurodesis For Pneumothoraxmentioning

confidence: 99%

“…102 Subsequent studies thereafter showed that VATS has similar pleurodesis success rates comparatively and also reduced postoperative pain and LOS. 99,103 Additional pleurodesis 104,105 and reinforcement of the staple line with sealants, glues, adhesives, and pericardial tissue 106 help to further reduce the recurrence rate. Mechanical pleural abrasion and pleurectomy are also suggested to help improve the success rate.…”

Section: Pleurodesis For Pneumothoraxmentioning

confidence: 99%

“…108 Graded talc is the sclerosant of choice, with doxycycline cited as an acceptable alternative. 99 ABP is also another possible alternative, with case series showing shorter leak time and high success rates of 84 to 97%. 53 Although there is a paucity of trials, ABP appears to be well tolerated and is effective even among secondary spontaneous pneumothoraxes.…”

Section: Pleurodesis For Pneumothoraxmentioning

confidence: 99%

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Pleurodesis

Lamb

Thakkar

et al. 2019

Semin Respir Crit Care Med

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Symptomatic pleural disease, specifically malignant pleural effusion, refractory benign pleural effusion, and pneumothoraces are common diseases that often require therapeutic interventions. The spectrum of management strategies often includes selection of a chemical pleurodesis agent administered in combination with an indwelling pleural catheter or chest tube.Additionally, there is a role for minimally invasive techniques which include medical thoracoscopy or more advanced video-assisted thoracoscopic approaches. Ongoing clinical trials continue to evolve best practices regarding the optimal sclerosant agents and procedural approaches in the management of these diseases.

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Thoracoabdominal Injuries

Kerr

Bowen

Light

2018

Contemporary Pediatric and Adolescent Sports Medicine

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Effectiveness of Thoracoscopic Talc Pleurodesis in the Management of Complicated Spontaneous Pneumothorax

Abstract: TTP is a safe and effective intervention in complicated spontaneous pneumothorax.

Cited by 12 publications

References 12 publications

Effectiveness of chemical pleurodesis in spontaneous pneumothorax recurrence prevention: a systematic review

Effectiveness of chemical pleurodesis in spontaneous pneumothorax recurrence prevention: a systematic review

Pleurodesis

Thoracoabdominal Injuries

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