title: The efficacy and economical benefits of blood patch pleurodesis in secondary spontaneous pneumothorax patients.
abstract: BACKGROUND
  Prolonged air leak in secondary spontaneous pneumothorax (SSP) patients remains one of the biggest challenges for thoracic surgeons. This study investigates the feasibility, effectiveness, clinical outcomes, and economical benefits of the autologous blood patch pleurodesis method in SSP.
  
  
  METHODS
  First-episode SSP patients undergoing autologous blood patch pleurodesis for resistant air leak following underwater-seal thoracostomy, between January 2010 and June 2013 were taken into the study. Timing and success rate of pleurodesis, recurrence, additional intervention, hospital length of stay, and complications that occurred during follow-up were examined from medical records, retrospectively.
  
  
  RESULTS
  Thirty-one (27 male, 4 female) SSP patients with expanded lungs on chest X-ray and resistant air leak on the 3(rd) post-interventional day were enrolled. Mean age was 53.7 ± 18.9 years (range: 23-81). Twenty-four patients were treated with tube thoracostomy, 2 with pezzer drain, and 5 with 8 F pleural catheter. 96.8% success was achieved; air leak in 29 of 31 patients (93.5%) ceased within the first 24 hours. No procedure-related complication such as fever, pain or empyema was seen. Late pneumothorax recurrence occurred in 4 (12.9%) patients; 1 treated with talc pleurodesis where the other 3 necessitated surgical intervention.
  
  
  CONCLUSIONS
  Autologous blood patch pleurodesis is a safe, effective, and easily performed procedure with no need of any additional equipment or extra cost. This method can be applied to all patients with radiologically expanded lungs and continuous air leak after 48 hours following water-seal drainage thoracostomy, to reduce hospital stay duration, unnecessary surgical interventions, and the expenses.
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Evman
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Alpay
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Serda
authors.initials: S
authors.lastname: Metin
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Kıral
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mine
authors.initials: M
authors.lastname: Demir
authors.affiliation: Department of Chest Diseases, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Yalçinsoy
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Volkan
authors.initials: V
authors.lastname: Baysungur
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Irfan
authors.initials: I
authors.lastname: Yalçinkaya
keywords: autoantigens; blood; pleurodesis; pneumothorax; spontaneous