Abstract
We herein present five cases of bilateral intractable secondary spontaneous pneumothorax associated with chronic severe lung diseases that were successfully treated with a modified form of a previously reported surgical procedure, the “total pleural covering technique,” under video-assisted thoracic surgery. We performed the total pleural covering technique modified with a preceding coverage of air-leak points with polyglycolic acid sheets. In this series, the median length of surgery was 106 min (range: 67–220 min) on the unilateral side (10 sides). No significant surgical complications were observed, but one patient died on day 23 after the operation, due to respiratory insufficiency on the basis of the underlying lung disease. The remaining four patients have been followed up regularly (mean follow-up time: 23 months; range: 1–54 months) and there has been no recurrences of pneumothorax. We believe that the total pleural covering technique is a useful method; however, special attention should be paid to the underlying disease in order to identify patients who would be most likely to benefit from the procedure.
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Almosa KF, Ryu JH, Mendez J, Huggins JT, Young LR, Sullivan EJ, et al. Management of pneumothorax in Lymphangioleiomyomatosis. Effect on recurrence and lung transplantation complications. Chest 2006;129:1274–1281.
Rinaldo JE, Owens GR, Rogers RM. Adult respiratory distress syndrome following intrapleural instillation of talc. J Thorac Cardiovasc Surg 1983;85:523–526.
Kurihara M, Kataoka H, Ishikawa A, Endo R. Latest treatments for spontaneous pneumothorax. Gen Thorac Cardiovasc Surg 2010;58:113–119.
Noda M, Okada Y, Kondo T, et al. An experience with modified total pleural covering technique in a patient with bilateral intractable pneumothorax secondary to lymphangioleiomyomatosis. Ann Thorac Cardiovasc Surg, in press
Kinoshita T, Miyoshi S, Katoh M, Yoshimasu T, Juri M, Maebeya S, et al. Intrapleural administration of a large amount of diluted fibrin glue for intractable pneumothorax. Chest 2000;117:790–795.
Kawamura M, Kase K, Sawafuji M, Watanabe M, Horinouchi H, Kobayashi K. Staple-line reinforcement with a new type of polyglycolic acid felt. Surg Laparosc Endosc Percutan Tech 2001;11:43–46.
Baumann MH, Strange C, Heffner JE, Light R, Kirby TJ, Klein J, et al. Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest 2001;119:590–602.
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Noda, M., Okada, Y., Maeda, S. et al. A total pleural covering technique in patients with intractable bilateral secondary spontaneous pneumothorax: Report of five cases. Surg Today 41, 1414–1417 (2011). https://doi.org/10.1007/s00595-010-4427-5
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DOI: https://doi.org/10.1007/s00595-010-4427-5