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Intraoperative mechanical and chemical pleurodesis with 50 % glucose solution for secondary spontaneous pneumothorax in patients with pulmonary emphysema.
MedLine Citation:
PMID:  23361597     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: Secondary spontaneous pneumothorax is life-threatening for patients with pulmonary emphysema. To prevent recurrence, intraoperative pleurodesis is performed in addition to bullectomy. We report the therapeutic process and effectiveness of adding mechanical plus chemical pleurodesis, with a 50 % glucose solution, to bullectomy, for patients with pulmonary emphysema-related pneumothorax. METHODS: The subjects were 20 patients (19 men and 1 woman; mean age 68 years) with pulmonary emphysema-related pneumothorax. After bullectomy was completed, 500 mL of a 50 % glucose solution was injected into the pleural cavity, followed by mechanical pleurodesis performed via ablation of the parietal pleura. RESULTS: The volume of pleural effusion decreased on postoperative day (POD) 1, and the temperature decreased on POD 2. The blood sugar levels increased on the day of surgery but decreased on POD 1. The mean postoperative follow-up period was 521 days. One patient died of pneumonia on POD 24. All other patients survived without pneumothorax recurrence. CONCLUSIONS: These results demonstrated the effectiveness of our treatment process for pulmonary emphysema-related pneumothorax. The fact that no patient experienced pneumothorax recurrence suggests that mechanical and chemical pleurodesis with 50 % glucose solution might be effective prophylaxis.
Authors:
Takuma Tsukioka; Kiyotoshi Inoue; Hiroko Oka; Shinjiro Mizuguchi; Ryuhei Morita; Noritoshi Nishiyama
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-31
Journal Detail:
Title:  Surgery today     Volume:  -     ISSN:  1436-2813     ISO Abbreviation:  Surg. Today     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204360     Medline TA:  Surg Today     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Thoracic Surgery, Bell Land General Hospital, 500-3 Higashiyama, Naka-ku, Sakai, 599-8247, Japan, t-tsukioka@med.osaka-cu.ac.jp.
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