Okado Shoji, Nakamura Shota, Sato Keiyu, Ueno Harushi, Ito Takayasu, Sato Kazuhide, Okachi Shotaro, Uehara Yohei, Matsumoto Misa, Shimazaki Natsumi, Miyagawa Katsuya, Chen-Yoshikawa Toyofumi Fengshi
Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Respiration. 2024;103(10):634-640. doi: 10.1159/000540652. Epub 2024 Jul 30.
A minimally invasive alternative to surgery for treating pneumothorax has been developed, aiming to reduce risks while maintaining efficacy. This study conducted basic experiments using ex vivo and in vivo pig lung employing a super-thin catheter for treatment. This new device injects fibrin glue directly into the responsible lesion to close the air leak, which has two features: thin design and double-lumen.
The experimental setup involved utilizing trachea and both lung specimens from pigs under positive pressure ventilation. To simulate pneumothorax, artificial fistulas were created on the lung surfaces. The super-thin catheter, guided through a bronchoscope near the fistula, was used to embolize the peripheral bronchus by injecting a fibrin preparation. Then, an air leak test was conducted afterward to assess the efficacy of the treatment. Additionally, a similar pneumothorax model was induced in alive pig under general anesthesia to evaluate its curability.
In the extracted pig lungs, embolization was performed in 21 cases, resulting in the cessation of air leaks in 19 cases, corresponding to a 90.5% cure rate. Notably, no major adverse events occurred with the treatment devices. Similarly, in living pigs, pneumothorax was successfully treated, with no recurrence observed up to the seventh postoperative day.
The novel treatment device utilizing a super-thin catheter offers a minimally invasive and highly curative option for pneumothorax. These promising results suggest the potential for further development and human clinical trials, which could revolutionize the treatment of pneumothorax, reducing risks and improving outcomes.
已开发出一种治疗气胸的微创替代手术方法，旨在降低风险同时保持疗效。本研究使用离体和活体猪肺进行基础实验，采用超薄导管进行治疗。这种新装置将纤维蛋白胶直接注入责任病灶以封闭漏气，它有两个特点：设计轻薄和双腔。
实验装置包括在正压通气下利用猪的气管和双侧肺标本。为模拟气胸，在肺表面制造人工瘘口。通过瘘口附近的支气管镜引导超薄导管，注入纤维蛋白制剂以栓塞外周支气管。然后进行漏气测试以评估治疗效果。此外，在全身麻醉下的活体猪中诱导类似的气胸模型以评估其治愈率。
在摘取的猪肺中，进行栓塞21例，其中19例漏气停止，治愈率为90.5%。值得注意的是，治疗装置未发生重大不良事件。同样，在活体猪中，气胸得到成功治疗，术后第7天未观察到复发。
利用超薄导管的新型治疗装置为气胸提供了一种微创且高治愈率的选择。这些有前景的结果表明有进一步开发和进行人体临床试验的潜力，这可能会彻底改变气胸的治疗方式，降低风险并改善治疗效果。
