Treatment of primary spontaneous pneumothorax by videothoracoscopic talc pleurodesis under local anesthesia: a review of 133 procedures

Ramos-Izquierdo, Ricard; Moya, Juan; Macía, Iván; Rivas, Francisco; Ureña, Anna; Rosado, Giovanna M.C.; Escobar, Ignacio; Saumench, J.; Cabrera, Arnold; Delgado, Marina Ayres; Villalonga, R.

doi:10.1007/s00464-009-0707-9

Cited by 22 publications

(16 citation statements)

References 19 publications

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“…Talc poudrage under thoracoscopy is a safe, cheap and very efficient agent for achieving pleurodesis provided graded talc is chosen for pleurodesis [119,120,141,142]. The recurrence rate seen after talc poudrage is comparable to that seen after mechanical pleurodesis [143][144][145]. Other sclerosing agents given via a chest tube have been used for prevention of pneumothorax, and include bleomycin dextrose, glucose 50%, iodine, tetracycline or talc slurry [146].…”

Section: Indicationsmentioning

confidence: 81%

ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax

et al. 2015

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Primary spontaneous pneumothorax (PSP) affects young healthy people with a significant recurrence rate. Recent advances in treatment have been variably implemented in clinical practice. This statement reviews the latest developments and concepts to improve clinical management and stimulate further research.The European Respiratory Society's Scientific Committee established a multidisciplinary team of pulmonologists and surgeons to produce a comprehensive review of available scientific evidence.Smoking remains the main risk factor of PSP. Routine smoking cessation is advised. More prospective data are required to better define the PSP population and incidence of recurrence. In first episodes of PSP, treatment approach is driven by symptoms rather than PSP size. The role of bullae rupture as the cause of air leakage remains unclear, implying that any treatment of PSP recurrence includes pleurodesis. Talc poudrage pleurodesis by thoracoscopy is safe, provided calibrated talc is available. Video-assisted thoracic surgery is preferred to thoracotomy as a surgical approach.In first episodes of PSP, aspiration is required only in symptomatic patients. After a persistent or recurrent PSP, definitive treatment including pleurodesis is undertaken. Future randomised controlled trials comparing different strategies are required. @ERSpublications A European Task Force reviews scientific evidence and suggests future research for primary spontaneous pneumothorax

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Section: Indicationsmentioning

confidence: 81%

ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax

et al. 2015

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“…Although there has been discussion about the risk of the acute respiratory distress syndrome with the use of talc for pleurodesis, it now seems pretty clear that graded large-particle talc does not lead to the acute respiratory distress syndrome, is safe in use and is the most effective sclerosing agent [31]. Talc poudrage with medical thoracoscopy has a long-term recurrence rate of 5% in experienced hands [30,32], similar to published recurrence rates with VATS, the most commonly used approach in current practice. As the pathological process associated with PSP is a diffuse one, it makes perfect sense that the most important aspect of recurrence prevention also addresses the pleura in a diffuse manner [33].…”

Section: Recurrence Preventionmentioning

confidence: 99%

Primary Spontaneous Pneumothorax: A Diffuse Disease of the Pleura

2012

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Primary spontaneous pneumothorax (PSP) is by definition not associated with any underlying lung disease. However, this does not mean that there is no underlying pathological process. It has become increasingly apparent over recent years that PSP is associated with diffuse and often bilateral abnormalities within the pleura and is not simply a disease caused by ruptured blebs/bullae. The pathological process includes emphysema-like changes, pleural porosity and inflammation. In this review, we summarise the recent advances in our understanding of the pathogenesis of PSP and discuss how this relates to management strategies for patients with PSP.

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“…Additionally, immunosuppressants including corticosteroids, which are frequently used for PSS, may aggravate persistent air leak; therefore, pneumothorax in patients with PSS often presents as a difficult-to-treat disease and prognosis is predicted to be poor. Chemical pleurodesis with tetracycline or talc has been successfully used (3–5), but pleurodesis is more usually performed once the air leak has resolved. Chemical pleurodesis using such agents can contribute to the onset of acute exacerbation of the interstitial fibrosis (4).…”

Section: Discussionmentioning

confidence: 99%

“…If there is no improvement despite conservative treatment, a more invasive approach may be necessary. Video-assisted thoracic surgery is the next option for patients with recurrent pneumothorax and those for whom conservative treatment was not successful (5,6). Due to the severity of their underlying disease itself and their respiratory condition, these patients are often not suitable candidates for surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Blood-patch pleurodesis for pneumothorax in lung fibrosis due to progressive systemic sclerosis: A case report

Kagohashi

Ohara

Shiozawa

et al. 2014

Experimental and Therapeutic Medicine

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Pneumothorax in patients with progressive systemic sclerosis (PSS) often presents as a difficult-to-treat disease. Autologous blood-patch pleurodesis has previously been used for the treatment of pneumothorax. Blood outside its own environment is an irritant; therefore, chest physicians must watch closely for an allergic reaction. The injection is simple, painless, causes no side effects, is an inexpensive treatment for pneumothorax and is available not only in patients with persistent air leak but also in those with residual air space. A case is reported here of blood-patch pleurodesis for pneumothorax in lung fibrosis due to PSS. As an alternative therapy for difficult-to-treat pneumothorax in patients with PSS with persistent air leak and residual air space, autologous blood-patch pleurodesis would be one of the treatment options.

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Treatment of primary spontaneous pneumothorax by videothoracoscopic talc pleurodesis under local anesthesia: a review of 133 procedures

Abstract: Thoracoscopic pleural talc pleurodesis as a treatment for recurrent pneumothorax is easy, safe, and rapid, and causes minimal morbidity and mortality.

Cited by 22 publications

References 19 publications

ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax

ERS task force statement: diagnosis and treatment of primary spontaneous pneumothorax

Primary Spontaneous Pneumothorax: A Diffuse Disease of the Pleura

Blood-patch pleurodesis for pneumothorax in lung fibrosis due to progressive systemic sclerosis: A case report

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