title: A total pleural covering technique in patients with intractable bilateral secondary spontaneous pneumothorax: Report of five cases.
abstract: We herein present five cases of bilateral intractable secondary spontaneous pneumothorax associated with chronic severe lung diseases that were successfully treated with a modified form of a previously reported surgical procedure, the "total pleural covering technique," under video-assisted thoracic surgery. We performed the total pleural covering technique modified with a preceding coverage of air-leak points with polyglycolic acid sheets. In this series, the median length of surgery was 106 min (range: 67-220 min) on the unilateral side (10 sides). No significant surgical complications were observed, but one patient died on day 23 after the operation, due to respiratory insufficiency on the basis of the underlying lung disease. The remaining four patients have been followed up regularly (mean follow-up time: 23 months; range: 1-54 months) and there has been no recurrences of pneumothorax. We believe that the total pleural covering technique is a useful method; however, special attention should be paid to the underlying disease in order to identify patients who would be most likely to benefit from the procedure.
authors.affiliation: Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-cho, Sendai, 980-8575, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Noda
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Okada
authors.forename: Sumiko
authors.initials: S
authors.lastname: Maeda
authors.forename: Tetsu
authors.initials: T
authors.lastname: Sado
authors.forename: Akira
authors.initials: A
authors.lastname: Sakurada
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Hoshikawa
authors.forename: Chiaki
authors.initials: C
authors.lastname: Endo
authors.forename: Takashi
authors.initials: T
authors.lastname: Kondo
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000150:complications*; D008297:Male; D011030:Pneumothorax / Q000209:etiology / Q000601:surgery*; D012008:Recurrence; D020775:Thoracic Surgery, Video-Assisted / Q000295:instrumentation / Q000379:methods*; D055815:Young Adult