Abstract
From 1978 to 1985 96 patients with their first spontaneous pneumothorax were randomised into three groups, receiving either treatment with simple drainage (34 patients), drainage with tetracycline pleurodesis (33 patients), or drainage with talc pleurodesis (29 patients). There were 58 men and 38 women, aged 18-88 years. There was no significant difference between the three groups in the mean time in hospital or the period for which the drains were retained. The incidence of infection, persistent pneumothorax, and relapse while in hospital was also similar for the three groups. At follow-up in 1987-89 patients could be accounted for, with an average follow-up period of 4.6 years. The incidence of recurrence was 36% in the simple drainage group, 13% in the tetracycline pleurodesis group, and 8% in the talc pleurodesis group. The difference between the talc and simple drainage groups was significant. None of the methods caused severe short or long term side effects or changes in the follow-up chest radiograph. Thoracoscopy, performed on admission in 85 patients, showed normal appearances in 73 patients and small cysts in 12. The thoracoscopic findings were of no value in predicting recurrence. Talc pleurodesis resulted in a significantly lower recurrence rate than simple drainage, tetracycline pleurodesis having intermediate efficacy.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Andersen B., Nielsen J. B. Recurrence risk in spontaneous pneumothorax. A follow-up of 178 initial occurrences in a Danish county in a ten-year period. Acta Chir Scand Suppl. 1965;356:160–166. [PubMed] [Google Scholar]
- Granke K., Fischer C. R., Gago O., Morris J. D., Prager R. L. The efficacy and timing of operative intervention for spontaneous pneumothorax. Ann Thorac Surg. 1986 Nov;42(5):540–542. doi: 10.1016/s0003-4975(10)60578-4. [DOI] [PubMed] [Google Scholar]
- Guérin J. C., Champel F., Biron E., Kalb J. C. Talcage pleural par thoracoscopie dans le traitement du pneumothorax. Etude d'une série de 109 cas traités en 3 ans. Rev Mal Respir. 1985;2(1):25–29. [PubMed] [Google Scholar]
- Hamilton A. A., Archer G. J. Treatment of pneumothorax by simple aspiration. Thorax. 1983 Dec;38(12):934–936. doi: 10.1136/thx.38.12.934. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Harvey J. E., Jeyasingham K. The difficult pneumothorax. Br J Dis Chest. 1987 Jul;81(3):209–216. doi: 10.1016/0007-0971(87)90152-5. [DOI] [PubMed] [Google Scholar]
- Krasnik M., Christensen B., Halkier E., Høier-Madsen K., Jelnes R., Wied U. Pleurodesis in spontaneous pneumothorax by means of tetracycline. Follow-up evaluation of a method. Scand J Thorac Cardiovasc Surg. 1987;21(2):181–182. doi: 10.3109/14017438709106520. [DOI] [PubMed] [Google Scholar]
- Lange P., Mortensen J., Groth S. Lung function 22-35 years after treatment of idiopathic spontaneous pneumothorax with talc poudrage or simple drainage. Thorax. 1988 Jul;43(7):559–561. doi: 10.1136/thx.43.7.559. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Larrieu A. J., Tyers G. F., Williams E. H., O'Neill M. J., Derrick J. R. Intrapleural instillation of quinacrine for treatment of recurrent spontaneous pneumothorax. Ann Thorac Surg. 1979 Aug;28(2):146–150. doi: 10.1016/s0003-4975(10)63772-1. [DOI] [PubMed] [Google Scholar]
- Mattila S., Kostiainen S. Spontaneous pneumothorax. Scand J Thorac Cardiovasc Surg. 1977;11(3):259–263. [PubMed] [Google Scholar]
- SMITH W. G., ROTHWELL P. P. Treatment of spontaneous pneumothorax. Thorax. 1962 Dec;17:342–349. doi: 10.1136/thx.17.4.342. [DOI] [PMC free article] [PubMed] [Google Scholar]
- So S. Y., Yu D. Y. Catheter drainage of spontaneous pneumothorax: suction or no suction, early or late removal? Thorax. 1982 Jan;37(1):46–48. doi: 10.1136/thx.37.1.46. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stradling P., Poole G. Conservative management of spontaneous pneumothorax. Thorax. 1966 Mar;21(2):145–149. doi: 10.1136/thx.21.2.145. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vanderschueren R. G. Le talcage pleural dans le pneumothorax spontané. Poumon Coeur. 1981;37(4):273–276. [PubMed] [Google Scholar]
- Verschoof A. C., Ten Velde G. P., Greve L. H., Wouters E. F. Thoracoscopic pleurodesis in the management of spontaneous pneumothorax. Respiration. 1988;53(3):197–200. doi: 10.1159/000195413. [DOI] [PubMed] [Google Scholar]
- Videm V., Pillgram-Larsen J., Ellingsen O., Andersen G., Ovrum E. Spontaneous pneumothorax in chronic obstructive pulmonary disease: complications, treatment and recurrences. Eur J Respir Dis. 1987 Nov;71(5):365–371. [PubMed] [Google Scholar]
- Weeden D., Smith G. H. Surgical experience in the management of spontaneous pneumothorax, 1972-82. Thorax. 1983 Oct;38(10):737–743. doi: 10.1136/thx.38.10.737. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wied U., Andersen K., Schultz A., Rasmussen E., Watt-Boolsen S. Silver nitrate pleurodesis in spontaneous pneumothorax. Scand J Thorac Cardiovasc Surg. 1981;15(3):305–307. doi: 10.3109/14017438109100592. [DOI] [PubMed] [Google Scholar]
- Wied U., Halkier E., Hoeier-Madsen K., Plucnar B., Rasmussen E., Sparup J. Tetracycline versus silver nitrate pleurodesis in spontaneous pneumothorax. J Thorac Cardiovasc Surg. 1983 Oct;86(4):591–593. [PubMed] [Google Scholar]