Effects of additional minocycline pleurodesis after thoracoscopic procedures for primary spontaneous pneumothorax.
OBJECTIVE
To evaluate the safety and efficacy of additional minocycline pleurodesis after thoracoscopic treatment of primary spontaneous pneumothorax.


METHODS
Retrospective comparative study with a historical control.


METHODS
Thoracic surgical division of a university-affiliated tertiary medical center.


METHODS
Between April 1994 and April 2001, 313 consecutive patients (minocycline group) with primary spontaneous pneumothorax were treated by video-assisted thoracoscopic surgery. The procedures included resection of the blebs and mechanical pleurodesis by scrubbing the parietal pleura. After operation, minocycline hydrochloride, 7 mg/kg, was instilled into the pleural space through a thoracostomy tube. The control group consisted of 51 consecutive patients who underwent the same thoracoscopic procedures alone for primary spontaneous pneumothorax between January 1992 and April 1994.


RESULTS
There was no significant difference between the two groups in terms of demographic data, operative findings, and operation time. Chest pain was a common complaint after minocycline pleurodesis, but the total doses of requested analgesics were comparable in both groups. The rate of prolonged air leaks was significantly lower in the minocycline group (7.0% vs 17.6%, p = 0.025). Patients treated with minocycline had shorter periods of postoperative chest drainage and hospitalization. The ipsilateral recurrence rate was also significantly lower in these patients (2.9% vs 9.8%, p = 0.033).


CONCLUSIONS
Minocycline pleurodesis is a safe and convenient procedure that may improve the outcome and reduce the rate of recurrence after thoracoscopic treatment for primary spontaneous pneumothorax. A randomized control study may be needed to confirm the findings.
Chen
Jin-Shing
JS
Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Hsu
Hsao-Hsun
HH
Kuo
Shuenn-Wen
SW
Tsai
Pi-Ru
PR
Chen
Robert J
RJ
Lee
Jang-Ming
JM
Lee
Yung-Chie
YC
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007509:Irritants / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000008:administration & dosage* / Q000009:adverse effects; D018700:Pleurodesis / Q000009:adverse effects; D011030:Pneumothorax / Q000601:surgery*; D011182:Postoperative Care; D012008:Recurrence; D020775:Thoracic Surgery, Video-Assisted
D007509:Irritants; D008911:Minocycline