Intrapleural administration of a large amount of diluted fibrin glue for intractable pneumothorax. A clinical study based on 57 cases: including 2 unsuccessful cases.
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.
Kinoshita
Takahiro
T
Department of Surgery, Koyo Hospital, Naga District Hospital, Wakayama, Japan.
Miyoshi
Shinichiro
S
Suzuma
Takaomi
T
Sakurai
Teruhisa
T
Enomoto
Katsumi
K
Yoshimasu
Tatsuya
T
Maebeya
Shinzi
S
Juri
Masanobu
M
Okamura
Yoshitaka
Y
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
D015718:Fibrin Tissue Adhesive