Original articleGeneral thoracicEfficacy of Polyglycolic Acid Sheet After Thoracoscopic Bullectomy for Spontaneous Pneumothorax
Section snippets
Patients and Methods
This study was approved by the Institutional Review Board of the Yonsei University College of Medicine (approval number 4-2010-0099). At preoperative workup, patients who agreed to the use of absorbable PGA sheet were assigned to group B, and those patients provided written informed consent.
Results
Patient age in group A was statistically higher than that in group B (23.67 ± 6.54 versus 21.69 ± 5.65 years; p = 0.010), whereas statistically significant differences in preoperative demographics that included sex, body mass index, smoking history, history of pulmonary tuberculosis, and pneumothorax site were not found (Table 1).
Number of wedge resections was not statistically different between groups (p = 0.971). There was no operative mortality or morbidity in either group. In this study,
Comment
PSP occurs in persons without underlying lung disease. It commonly occurs in thin or tall young male individuals between the ages of 10 and 30 years and rarely occurs in persons older than 40 years 1, 6, 7. In patients treated with conservative therapy for PSP (observation, needle aspiration, or chest tube drainage), the average recurrence rate is 30% (16%–52%) [8]. Therefore, surgical management is required to decrease the recurrence of PSP.
In the past, open bullectomy was the gold standard
References (24)
- et al.
Lung wedge resection improves outcome in stage I primary spontaneous pneumothorax
Ann Thorac Surg
(2004) - et al.
Percutaneous parietal pleurectomy for recurrent spontaneous pneumothorax
Lancet
(1990) - et al.
Videothoracoscopic ligation of bulla and pleurectomy for spontaneous pneumothorax
Ann Thorac Surg
(1991) - et al.
Long-term results after video-assisted thoracoscopic surgery for first-time and recurrent spontaneous pneumothorax
Ann Thorac Surg
(2000) - et al.
Video-assisted thoracoscopic surgery versus thoracotomy for spontaneous pneumothorax
Ann Thorac Surg
(1994) - et al.
Videothoracoscopic bleb excision and pleural abrasion for the treatment of primary spontaneous pneumothorax: long-term results
Ann Thorac Surg
(2003) - et al.
Efficacy study of video-assisted thoracoscopic surgery pleurodesis for spontaneous pneumothorax
Ann Thorac Surg
(2001) - et al.
Efficiency of video-assisted thoracic surgery for primary and secondary spontaneous pneumothorax
Ann Thorac Surg
(1998) - et al.
Spontaneous pneumothorax
N Engl J Med
(2000) - et al.
Recurrence of primary spontaneous pneumothorax
Thorax
(1997)
Impact of additional pleurodesis in video-assisted thoracoscopic bullectomy for primary spontaneous pneumothorax
Surg Endosc
Staple line coverage with absorbable mesh after thoracoscopic bullectomy for spontaneous pneumothorax
Surg Endosc
Cited by (35)
Thickened parietal pleural covering in intractable pneumothorax: A case report
2022, Annals of Medicine and SurgeryCitation Excerpt :The optimal choice of surgical treatment for intractable pneumothorax is complex. If air leaks are present, making resection unsuitable, and pleurodesis [1], fibrin glue injection [2], covering with artificial material [3], bronchial occlusion using Endobronchial Watanabe Spigot (silicone spigot, EWS®, Novatech, LaCiotat, France) [4], and the use of other bronchial valves must be considered. Treatment failure using these approaches necessitates the consideration of an autologous material for covering [5].
Vicryl Mesh Coverage Reduced Recurrence After Bullectomy for Primary Spontaneous Pneumothorax
2021, Annals of Thoracic SurgeryCitation Excerpt :One of the concerns about the pleural symphysial procedure is severe and extensive pleural adhesion, such as the talc effect,16 which may negatively affect future interventions in the pleural space if required.17 One cohort study reported that the use of a polyglycolic acid sheet fixed with a blood patch in addition to abrasion pleurodesis could prevent recurrence of pneumothorax.10 In their study, however, fibrin glue or a blood patch was used in addition to the mesh.
Evaluation of pleurodesis by poly-ε-caprolactone (PCL) gel in an animal model using New Zealand white rabbits
2019, Asian Journal of SurgeryCitation Excerpt :More and more need for pleurodesis using some kind of biomaterial is noted in recent years when treating pleural diseases.1–3
Study of poly-ɛ-caprolactone membranes for pleurodesis
2017, Journal of the Formosan Medical AssociationCitation Excerpt :A potential alternative to increase the intensity of pleural inflammation and thereby prevent pneumothorax recurrence is film pleurodesis. Only a few studies have been reported in which more than one film pleurodesis has been tried,12,13 and the mechanism of film pleurodesis remains unclear. Poly-ɛ-caprolactone (PCL) is a biomaterial approved by the US Food and Drug Administration, with a slow degradation time of ∼24 months when degraded by hydrolysis alone.14–18
Optimal surgical technique in spontaneous pneumothorax: a systematic review and meta-analysis
2017, Journal of Surgical ResearchCitation Excerpt :In the wedge resection + pleural abrasion + chemical pleurodesis group, two treatment arms used talc and two treatment arms used minocycline.11-18 Reinforcement of the staple line was preformed using polyglycolic acid sheets (three treatment arms), fibrinogen-based collagen fleece (one treatment arm), cellulose mesh (two treatment arms), Vicryl mesh (two treatment arms), and fibrin glue (one treatment arm).19-25 A total of 51 studies reported data for 65 treatment arms for the outcome recurrence rates.