Dr. Uramoto and Tanaka have no competing interests and conflict of interest or financial ties to disclose.
This report reflects the opinion of the authors and does not represent the official position of any institution or sponsor. The contributions of each of the authors were as follows. HU were responsible for reviewing previous research, journal hand searching, and drafting report. FT was responsible for project coordination. All authors have read and approved the final manuscript.
The purpose of this retrospective study was to identify an appropriate material that can be used as a covering for patients with a spontaneous pneumothorax (SP). A total of 279 patients were studied over a period of eight years.
The patient characteristics, surgical details and perioperative outcomes were analyzed. We compared the clinicopathological characteristics between recurrent and non-recurrent cases, and examined the associations with the material used for covering the SP, such as polyglycolic acid (PGA) sheets, a fibrinogen-based collagen fleece (TachoComb; TC) or regenerated oxidized cellulose mesh (ROCM).
The differences in the gender, smoking habits, lesion site, location, comorbidities, ipsilateral spontaneous pneumothorax (ISP), contralateral spontaneous pneumothorax (CSP) and surgery for ISP did not reach statistical significance between the patients treated with a covering of ROCM and those treated with PGA/TC, although the age of the patients was significantly different in these groups, with the ROCM group having younger patients (p = 0.024). The length of the operation was significantly shorter in the ROCM group (mean: 76.7 minutes) than in the PGA/TC cases (130.4 minutes, p = 0.015). Concerning the intraoperative factors, there were no significant differences with regard to the approach, buttress stapling, covering or surgeon. No postoperative recurrence was observed in this series. There were no significant differences in the perioperative outcomes. However, the drainage period was shorter in subjects who underwent covering with the ROCM (mean: 1.125 days) than with the PGA/TC (2.412 days, p = 0.030). Further, the hospital stay had a tendency to be shorter in subjects who underwent covering with ROCM than with PGA/TC.
ROCM might be superior to PGA/TC as a material for covering SP in terms of the length of the operation and the drainage period. ROCM might decrease the hospital stay and the postoperative recurrence. Prospective studies in a larger cohort of patients will be necessary to define the optimal surgical technique to suppress the recurrence of SP.
Luh SP, Chou HH, Tsai TP, Chen JY, Chou MC, Wang YH, Lee CJ: Effect of Surgicel coverage with topical electrocauterization for preventing and sealing pulmonary air leakage. Int Surg. 2004, 89: 190-194. PubMed
Biçer M, Bayram AS, Gürbüz O, Senkaya I, Yerci O, Tok M, Anğ E, Moğol EB, Saba D: Assessment of the efficacy of bio-absorbable oxidized regenerated cellulose for prevention of post-operative pericardial adhesion in the rabbit model. J Int Med Res. 2008, 36: 1311-1318. 10.1177/147323000803600619. CrossRefPubMed
Kurihara M, Kataoka H, Ebana H, Endo R: Chemical pleurodesis should absolutely be avoided to prevent LAM patients from recurrent pneumothorax considering lung transplantation (clinical and experimental study of total pleural covering technique). 2008, Cincinnati, OH: Presented at the LAM Symposium
- What is an appropriate material to use with a covering technique to prevent the recurrence of spontaneous pneumothorax?
- BioMed Central
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