An experience with the modified total pleural covering technique in a patient with bilateral intractable pneumothorax secondary to lymphangioleiomyomatosis.
We present a case of bilateral intractable pneumothorax associated with a modified form of lymphangioleiomyomatosis (LAM), successfully treated with a previously reported surgical procedure, the total pleural covering (TPC) technique, under video-assisted thoracic surgery. The patient was a 28-year-old woman with bilateral pneumothorax secondary to LAM who had undergone thoracoscopic surgery in another hospital. We performed bilateral TPC modified with a preceding coverage of air leak points with polyglycolic acid sheets for reinforcement. Although a minor air leak after the surgery necessitated a mild pleurodesis on the right side, the bilateral pneumothorax was well controlled, and no recurrence has been observed for 9 months. We believe that TPC is a safe and reliable procedure for the management of intractable pneumothorax secondary to LAM. It also has the potential to reduce risk of excessive bleeding in lung transplantation.
Department of Thoracic Surgery, Institute of Development, Aging, and Cancer, Tohoku University, Sendai, Japan.
Masafumi
M
Noda
Yoshinori
Y
Okada
Sumiko
S
Maeda
Tetsu
T
Sado
Akira
A
Sakurada
Yasushi
Y
Hoshikawa
Chiaki
C
Endo
Takashi
T
Kondo
D000287:Administration, Topical; D000328:Adult; D002483:Cellulose, Oxidized / Q000008:administration & dosage*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D006801:Humans; D018192:Lymphangioleiomyomatosis / Q000150:complications*; D010994:Pleura / Q000601:surgery*; D011030:Pneumothorax / Q000209:etiology / Q000628:therapy*; D013526:Surgical Mesh; D020775:Thoracic Surgery, Video-Assisted; D014014:Tissue Adhesives / Q000008:administration & dosage*
D002483:Cellulose, Oxidized; D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives