PURPOSE: Bullectomy, hypodesis and talc poudrage via thoracotomy or video assisted thoracoscopy (VATS) are common methods in treating persistent and recurrent spontaneous pneumothorax, with somewhat complexity and higher expense. More simple, safe and lower expense methods are needed. Our objectives were to evaluate the efficacy and safety of administration of anastomotic glue via VATS under local anesthesia in treating pneumothorax .
METHODS: From 6/1999 to 6/2008, 98 patients with pneumothorax of different causes, most idiopathic, were undergone video assisted thoracoscopy with local anesthesia after routine closed drainage of thoracic cavity. Anastomotic glue was injected into the bullae and fistulas or smeared on the surface of the lung. The efficacy and side effects were evaluated.
RESULTS: 1-6 bullae were seen on surface of lungs, mostly upper lobes, in 63 of 98 patients (64.3%). Bronchopleural fistulas were observed in 3 patients (3.1%). Complete expansion of the lung was obtained in 79 patients (80.6%) in the first 24 hours after anastomotic glue treating, 13 patients during 1~7 days (13.3%) and in 6(6.1%) 7 days later. Recurrece was observed in 7 patients (7.1%) after follow up of 2~10years. Most patients felt chest pain in several hours after treating due to the glue irritating.
CONCLUSIONS: Administration of anastomotic glue via VATS under local anesthesia is effective to treating pneumothorax of different causes, especially useful in treating persistent and recurrent spontaneous pneumothorax, with relatively simple course and lower expense.
CLINICAL IMPLICATIONS: Although improvement should be made, our results suggest that anastomotic glue treatment via VATS under local anesthesia may be an relatively simple and lower expense alternative to pneumothorax treating methods
DISCLOSURE: The following authors have nothing to disclose: Jianlin Hu
No Product/Research Disclosure Information