Evman Serdar, Alpay Levent, Metin Serda, Kıral Hakan, Demir Mine, Yalçinsoy Murat, Baysungur Volkan, Yalçinkaya Irfan
Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
Department of Chest Diseases, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
Kardiochir Torakochirurgia Pol. 2016 Mar;13(1):21-5. doi: 10.5114/kitp.2016.58960. Epub 2016 Mar 30.
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.
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.
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.
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.
继发性自发性气胸（SSP）患者的持续性漏气仍然是胸外科医生面临的最大挑战之一。本研究探讨自体血贴片胸膜固定术在SSP中的可行性、有效性、临床结果和经济效益。
纳入2010年1月至2013年6月间因胸腔闭式引流术后持续性漏气而接受自体血贴片胸膜固定术的初发性SSP患者。通过回顾病历，检查胸膜固定术的时机和成功率、复发情况、额外干预措施、住院时间以及随访期间发生的并发症。
纳入31例（27例男性，4例女性）胸部X线显示肺膨胀且介入后第3天持续性漏气的SSP患者。平均年龄为53.7±18.9岁（范围：23 - 81岁）。24例患者接受了胸腔闭式引流术，2例接受了Pezzer引流管引流，5例接受了8F胸膜导管引流。成功率达到96.8%；31例患者中有29例（93.5%）的漏气在最初24小时内停止。未观察到与手术相关的并发症，如发热、疼痛或脓胸。4例（12.9%）患者出现迟发性气胸复发；1例接受滑石粉胸膜固定术治疗，另外3例需要手术干预。
自体血贴片胸膜固定术是一种安全、有效且易于实施的手术，无需任何额外设备或额外费用。该方法可应用于所有胸腔闭式引流术后48小时后肺部影像学显示膨胀且持续漏气的患者，以缩短住院时间、减少不必要的手术干预和费用。
