title: Management and prevention of spontaneous pneumothorax using pleurodesis in Hong Kong.
abstract: BACKGROUND
  The practice of pleurodesis for the management and prevention of spontaneous pneumothorax (SP) is uncertain.
  
  
  METHODS
  A retrospective multicentre analysis of patients admitted to 12 hospitals in Hong Kong with SP in 2004 and who subsequently underwent pleurodesis for the same episode.
  
  
  RESULTS
  Pleurodesis was performed in 394 episodes. Initial medical chemical pleurodesis was performed for 258 (65.5%) patients ('initial medical group'), while 136 (34.5%) underwent initial surgical pleurodesis ('initial surgical group'). Secondary spontaneous pneumothorax (SSP; 237 episodes, 60.2%) was the most common indication for pleurodesis; it was also performed after a first episode of primary spontaneous pneumothorax (PSP) in 22 episodes (5.6%). Tetracycline derivatives (172 episodes, 66.7%) were the most popular sclerosing agents in the initial medical group. Those in the initial medical group were older and were more likely to be males, have SSP, chronic obstructive pulmonary disease and a history of past pleurodesis (P < 0.05) compared to the initial surgical group. Compared to the tetracycline group, more patients who initially received talc slurry had the procedure performed by surgeons, had larger (≥2 cm) pneumothorax or required suction during initial drainage (P < 0.05).
  
  
  CONCLUSIONS
  Despite the availability of international guidelines, there is considerable variation in pleurodesis for SP.
authors.affiliation: Department of Medicine, Queen Elizabeth Hospital, Hong Kong, SAR China. chanwmj@ha.org.hk
authors.forename: J W
authors.initials: JW
authors.lastname: Chan
authors.forename: F W
authors.initials: FW
authors.lastname: Ko
authors.forename: C K
authors.initials: CK
authors.lastname: Ng
authors.forename: A
authors.initials: A
authors.lastname: Yeung
authors.forename: W K S
authors.initials: WK
authors.lastname: Yee
authors.forename: L K Y
authors.initials: LK
authors.lastname: So
authors.forename: B
authors.initials: B
authors.lastname: Lam
authors.forename: M M L
authors.initials: MM
authors.lastname: Wong
authors.forename: K L
authors.initials: KL
authors.lastname: Choo
authors.forename: A S S
authors.initials: AS
authors.lastname: Ho
authors.forename: P Y
authors.initials: PY
authors.lastname: Tse
authors.forename: S L
authors.initials: SL
authors.lastname: Fung
authors.forename: C K
authors.initials: CK
authors.lastname: Lo
authors.forename: W C
authors.initials: WC
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D018700:Pleurodesis / Q000379:methods*; D011030:Pneumothorax / Q000517:prevention & control / Q000628:therapy*; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D012737:Sex Factors; D013627:Talc / Q000008:administration & dosage; D013754:Tetracyclines / Q000008:administration & dosage
chemical_list: D012597:Sclerosing Solutions; D013754:Tetracyclines; D013627:Talc