Latest treatments for spontaneous pneumothorax.
OBJECTIVE
Currently, the treatment of pneumothorax varies among hospitals. Three factors account for the differences. First, pneumothorax expresses the state of disease instead of the disease itself. Some pneumothoraces heal on their own but patients with pneumothorax due to chronic diseases may need further intervention. The decision for the choice of treatment is up to the physician. Second, it is insufficient to treat pneumothorax with current treatment guidelines. Third, prognosis and follow-up after pneumothorax treatment is not well documented. Therefore, verification/assessment of treatment and its effect is insufficient.


METHODS
To prevent postoperative bulla neogenesis, the "covering technique" is most effective. Chemical pleurodesis has shown a great number of recurrences and has led to inconveniences, such as various results among individuals. Therefore, it should not be the recommended therapy.


CONCLUSIONS
Intractable pneumothorax in elderly patients has been increasing year after year. Interventional treatments such as endobronchial Watanabe spigot embolization and the thoracographic fibrin glue sealing method are expected to become more common in the future, keeping some patients from undergoing surgery. Causes are still unknown for certain pneumothoraces in women, and there are still numerous cases of postoperative recurrence among young males. Further studies in this field are expected in future.
Kurihara
Masatoshi
M
Pneumothorax Research Center and Thoracic Surgery Division, Nissan Tamagawa Hospital, 4-8-1 Seta, Setagaya-ku, Tokyo, 156-0095, Japan. kuri@tf6.so-net.ne.jp
Kataoka
Hideyuki
H
Ishikawa
Aki
A
Endo
Reina
R
D000293:Adolescent; D004621:Embolization, Therapeutic; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006801:Humans; D008297:Male; D018700:Pleurodesis / Q000009:adverse effects; D011030:Pneumothorax / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D017410:Practice Guidelines as Topic; D012008:Recurrence; D018570:Risk Assessment; D019616:Thoracic Surgical Procedures / Q000009:adverse effects; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive