title: Effectiveness of Polyglycolic Acid Sheet Covering and Platelet-Rich Plasma after Video-Assisted Thoracic Surgery for Spontaneous Pneumothorax.
abstract: BackgroundVideo-assisted thoracic surgery (VATS) is widely used for the treatment of spontaneous pneumothorax, and the recurrence rate is high. The goal of the study was to examine the use of polyglycolic acid (PGA) sheets, together with platelet-rich plasma (PRP) from autologous blood for the prevention of postoperative recurrence of spontaneous pneumothorax.Materials and MethodsWe performed a retrospective study of 65 patients who underwent VATS for spontaneous pneumothorax from March 2008 to November 2011. The patients were divided into groups: without reinforcement (Group A,n= 33) and with reinforcement of the visceral pleura around the staple lines with the PGA sheet and PRP (Group B,n= 32). The postoperative follow-up period was 18 months.ResultsChest tubes were used for 3.4 and 3.1 days in Groups A and B, respectively, with no significant difference between the groups. However, the recurrence rate (18.2%; 6 cases) in Group A was significantly higher than that in Group B (p= 0.02). The recurrence rates in patients younger than 25 years in Group A and Group B were 26.1 and 0.0%, respectively (p= 0.03). In Group A, the mean age with recurrence (18.3 years old) was significantly lower than the mean age without recurrence (p= 0.03).ConclusionThese results suggest that the use of PGA sheets and PRP might be effective for the prevention of postoperative recurrence of spontaneous pneumothorax.
authors.affiliation: Respiratory Disease Center, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kimura
authors.affiliation: Department of Thoracic Surgery, Niizashiki Central General Hospital, Saitama, Japan.
authors.forename: Kuniharu
authors.initials: K
authors.lastname: Miyajima
authors.affiliation: Department of Thoracic Surgery, Niizashiki Central General Hospital, Saitama, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Kono
authors.affiliation: Respiratory Disease Center, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
authors.forename: Aeru
authors.initials: A
authors.lastname: Hayashi
authors.affiliation: Department of Diagnostic Pathology, National Defense Medical College, Saitama, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Iwaya
authors.affiliation: First Department of Surgery, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Ikeda
mesh_terms: D000293:Adolescent; D000328:Adult; D001672:Biocompatible Materials; D015505:Chest Tubes; D002648:Child; D004322:Drainage / Q000295:instrumentation; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D053657:Platelet-Rich Plasma; D011030:Pneumothorax / Q000175:diagnosis / Q000601:surgery*; D011100:Polyglycolic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D012008:Recurrence; D012189:Retrospective Studies; D017792:Surgical Stapling; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D011100:Polyglycolic Acid