title: Intrapleural administration of a large amount of diluted fibrin glue for intractable pneumothorax. A clinical study based on 57 cases: including 2 unsuccessful cases.
abstract: OBJECTIVE
  Pleurodesis using chemical agents has been applied to high-risk patients with pneumothorax. This treatment, however, is sometimes unsuccessful in patients with intractable pneumothorax. We have developed intrapleural administration of diluted fibrin glue as an effective treatment for such patients.
  
  
  METHODS
  Fibrin glue was diluted 4-fold with saline and/or contrast media. Pleurodesis with a large amount of the diluted fibrin glue was performed in 55 high risk patients (57 cases, bil.2 patients) with intractable pneumothorax.
  
  
  RESULTS
  The air leaks were stopped by administration of the glue in all except 2 patients. During the follow-up period, a recurrence rate of 10.5% was observed. These recurrent pneumothoraces were successfully treated using the same procedure with no further recurrence. Pyrexia (12.3%) and chest discomfort (8.8%) were observed as side effects, and there was no occurrence of severe chest pain or thoracic empyema.
  
  
  CONCLUSIONS
  These results suggested that intrapleural administration of a large amount of diluted fibrin glue was an effective treatment for intractable pneumothoraces in high-risk patients.
authors.affiliation: Department of Surgery, Koyo Hospital, Naga District Hospital, Wakayama, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyoshi
authors.forename: Takaomi
authors.initials: T
authors.lastname: Suzuma
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Sakurai
authors.forename: Katsumi
authors.initials: K
authors.lastname: Enomoto
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yoshimasu
authors.forename: Shinzi
authors.initials: S
authors.lastname: Maebeya
authors.forename: Masanobu
authors.initials: M
authors.lastname: Juri
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Okamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D035422:Pleural Cavity; D018700:Pleurodesis / Q000379:methods*; D011030:Pneumothorax / Q000628:therapy*; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive