Intrapleural minocycline pleurodesis for the treatment of primary spontaneous pneumothorax.
OBJECTIVE
The role of chemical pleurodesis in the treatment of primary spontaneous pneumothorax remains unclear. According to current practice guidelines, chemical pleurodesis is reserved for patients who are unable or unwilling to have surgery. Some recent studies showed that intrapleural minocycline pleurodesis could decrease the rate of pneumothorax recurrence, when used either as the initial treatment for simple pneumothorax after successful aspiration and drainage or as an adjuvant treatment for complicated or recurrent pneumothorax following thoracoscopic surgery. The purpose of this review is to discuss the current available evidence on intrapleural minocycline pleurodesis for the treatment of primary spontaneous pneumothorax.


RESULTS
In a recently published prospective, randomized controlled trial, additional minocycline pleurodesis following simple aspiration and drainage was a well tolerated and more effective initial treatment for a first episode of primary spontaneous pneumothorax than simple aspiration and drainage alone. Other prospective, randomized controlled trials showed that additional minocycline pleurodesis after thoracoscopic treatment was a well tolerated and convenient procedure which can reduce the rate of ipsilateral recurrence of primary spontaneous pneumothorax.


CONCLUSIONS
Intrapleural minocycline pleurodesis can be considered an adjunct to standard treatment of primary spontaneous pneumothorax, after either simple aspiration and drainage or after thoracoscopic surgery.
aDepartment of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine bDepartment of Medical Research, National Taiwan University Hospital cDepartment of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
Jin-Shing
JS
Chen
Wing-Kai
WK
Chan
Pan-Chyr
PC
Yang
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002637:Chest Pain / Q000209:etiology / Q000517:prevention & control; D004322:Drainage / Q000379:methods*; D006801:Humans; D008911:Minocycline / Q000008:administration & dosage*; D009294:Narcotics / Q000008:administration & dosage; D018700:Pleurodesis / Q000379:methods; D011030:Pneumothorax / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013906:Thoracoscopy / Q000009:adverse effects; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D009294:Narcotics; D008911:Minocycline