Management of Spontaneous Pneumothorax

Baumann, Michael H.

doi:10.1002/9780470755969.ch21

Cited by 1 publication

(3 citation statements)

References 73 publications

(101 reference statements)

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“…The most frequent factor seen is COPD, and it is responsible approximately in 70% of all patients [ 1 , 11 , 12 ]. Airway and parenchymal infections, malignancies, connective tissue or interstitial lung diseases, and thoracic endometriosis causing catamenial pneumothorax can be listed as other underlying factors in SSP patients [ 11 – 15 ]. Secondary spontaneous pneumothorax seen in pediatric patients should bring up the probability of a congenital malformation or a foreign body aspiration [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Because of reported mortality rates between 1% and 17%, all patients are recommended to be hospitalized and followed with an underwater seal drainage; advocating a conservative approach has no place in the treatment of SPP [ 4 , 11 ]. Because of its severity and resistance to tube drainage, SSP is a dreaded clinical condition for thoracic surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…Underwater seal tube thoracostomy (TT) is the first-line treatment of choice in the first attack in SSP patients. It has been advocated by many authors and recent guidelines that chemical pleurodesis and/or video-thoracoscopic surgical intervention should be planned for patients with resistant air leak on the 48 th hour following TT [ 4 , 5 , 11 , 12 , 16 ]. Recurrence rates of 40-50% have been reported in SSP patients without additional treatment other than TT [ 11 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

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The efficacy and economical benefits of blood patch pleurodesis in secondary spontaneous pneumothorax patients

Evman

Alpay

Metin

et al. 2016

kitp

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IntroductionProlonged air leak in secondary spontaneous pneumothorax (SSP) patients remains one of the biggest challenges for thoracic surgeons. This study investigates the feasibility, effectiveness, clinical outcomes, and economical benefits of the autologous blood patch pleurodesis method in SSP.Material and methodsFirst-episode SSP patients undergoing autologous blood patch pleurodesis for resistant air leak following underwater-seal thoracostomy, between January 2010 and June 2013 were taken into the study. Timing and success rate of pleurodesis, recurrence, additional intervention, hospital length of stay, and complications that occurred during follow-up were examined from medical records, retrospectively.ResultsThirty-one (27 male, 4 female) SSP patients with expanded lungs on chest X-ray and resistant air leak on the 3rd post-interventional day were enrolled. Mean age was 53.7 ± 18.9 years (range: 23-81). Twenty-four patients were treated with tube thoracostomy, 2 with pezzer drain, and 5 with 8 F pleural catheter. 96.8% success was achieved; air leak in 29 of 31 patients (93.5%) ceased within the first 24 hours. No procedure-related complication such as fever, pain or empyema was seen. Late pneumothorax recurrence occurred in 4 (12.9%) patients; 1 treated with talc pleurodesis where the other 3 necessitated surgical intervention.ConclusionsAutologous blood patch pleurodesis is a safe, effective, and easily performed procedure with no need of any additional equipment or extra cost. This method can be applied to all patients with radiologically expanded lungs and continuous air leak after 48 hours following water-seal drainage thoracostomy, to reduce hospital stay duration, unnecessary surgical interventions, and the expenses.

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