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Pleural Abrasion

  • Uliano MorandiEmail author
  • Alessandro Stefani
  • Christian Casali
Chapter
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Abstract

Pleural abrasion represents a surgical technique to achieve pleural symphysis in order to prevent recurrence in spontaneous pneumothorax. It can be performed either by thoracotomy or VATS. Pleural abrasion is obtained by scrubbing the parietal pleura until a uniform aspect of bloody pleura is achieved. Various tools can be used for this purpose, such as meshes, gauzes, sponges, the electrosurgical tip cleaner or pleural abraders especially fit for VATS. The recurrence rate of pneumothorax after pleural abrasion varies from 0% to 10%, according to the type of surgical approach, with thoracotomy having the lowest rate of recurrences but the drawbacks of a more invasive approach. Considering the balance between effectiveness and risks, pleural abrasion performed by VATS is considered today as the procedure of choice for the treatment of spontaneous pneumothorax.

Keywords

Spontaneous Pneumothorax Parietal Pleura Primary Spontaneous Pneumothorax Mechanical Abrasion Pleural Empyema 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Almind M, Lange P, Viskum K (1989) Spontaneous pneumothorax: comparison of simple drainage, talc pleurodesis and tetracycline pleurodesis. Thorax 44:627–630PubMedCrossRefGoogle Scholar
  2. 2.
    Ayed AK, Al-Din HJ (2000) Video-assisted thoracoscopy versus thoracotomy for primary spontaneous pneumothorax: a randomized controlled trial. Med Princ Pract 9:113–118CrossRefGoogle Scholar
  3. 3.
    Barker A, Maratos EC, Edmonds L et al (2007) Recurrence rates of video-assisted thoracoscopic versus open surgery in the prevention of recurrent pneumothoraces: a systematic review of randomised and non-randomised trials. Lancet 370:329–335PubMedCrossRefGoogle Scholar
  4. 4.
    Baumann MH, Strange C (1997) Treatment of spontaneous pneumothorax: a more aggressive approach? Chest 112:789–804PubMedCrossRefGoogle Scholar
  5. 5.
    Baumann MH, Strange C, Heffner JE et al (2001) Management of spontaneous pneumothorax. An American College of Chest Physicians Delphi Consensus Statement. Chest 119:590–602PubMedCrossRefGoogle Scholar
  6. 6.
    Ben Nun A, Soudack M, Best LA (2006) Video-assisted thoracoscopic surgery for recurrent spontaneous pneumothorax: the long-term benefit. World J Surg 30:285–290PubMedCrossRefGoogle Scholar
  7. 7.
    Bertrand PC, Regnard JF, Spaggiari L et al (1996) Immediate and long-term results after surgical treatment of primary spontaneous pneumothorax. Ann Thorac Surg 61:1641–1645PubMedCrossRefGoogle Scholar
  8. 8.
    Bobbio A, Ampollini L, Internullo E et al (2006) Thoracoscopic parietal pleural argon beam coagulation versus pleural abrasion in the treatment of primary spontaneous pneumothorax. Eur J Cardiothorac Surg 29:6–8PubMedCrossRefGoogle Scholar
  9. 9.
    Bresticker MA, Oba J, LoCicero J et al (1993) Optimal pleurodesis: a comparison study. Ann Thorac Surg 55:364–367PubMedCrossRefGoogle Scholar
  10. 10.
    Chang YC, Chen CW, Huang SH et al (2006) Modified needlescopic video-assisted thoracic surgery for primary spontaneous pneumothorax: the long-term effects of apical pleurectomy versus pleural abrasion. Surg Endosc 20:757–762PubMedCrossRefGoogle Scholar
  11. 11.
    Cheynel N, Bernard A, Belichard C et al (1994) Comparative study of thoracoscopy and thoracotomy in spontaneous pneumothorax. Lyon Chir 90:193–196Google Scholar
  12. 12.
    Clagett OT (1968) The management of spontaneous pneumothorax. J Thorac Cardiovasc Surg 55:761–762PubMedGoogle Scholar
  13. 13.
    Colt HG, Russack V, Chiu Y et al (1997) A comparison of thoracoscopic talc insufflation, slurry and mechanical abrasion pleurodesis. Chest 111:442–448PubMedCrossRefGoogle Scholar
  14. 14.
    DeHoyos A, Fry WH (2009) Pneumothorax. In: Shields TW, Locicero J III, Reed CE, Feins RH (eds) General thoracic surgery. Lippincott Williams and Wilkins, PhiladelphiaGoogle Scholar
  15. 15.
    Dumont P, Diemont F, Massard G et al (1997) Does a thoracoscopic approach for surgical treatment of spontaneous pneumothorax represent progress? Eur J Cardiothorac Surg 11:27–31PubMedCrossRefGoogle Scholar
  16. 16.
    Freixenet JJG, Rodriguez P, Santana N (2001) Axillary thoracotomy versus video-assisted thoracoscopy in the surgical treatment of primary spontaneous pneumothorax. Eur Respir J 18:524Google Scholar
  17. 17.
    Gaensler EA (1956) Parietal pleurectomy for recurrent spontaneous pneumothorax. Surg Gynecol Obstet 102:293–308PubMedGoogle Scholar
  18. 18.
    Globbel WG, Rhea WG, Nelson IA (1963) Spontaneous pneumothorax. J Thorac Cardiovasc Surg 46:331–334Google Scholar
  19. 19.
    Gossot D, Galetta D, Stern JB et al (2004) Results of thoracoscopic pleural abrasion for primary spontaneous pneumothorax. Surg Endosc 18:466–471PubMedCrossRefGoogle Scholar
  20. 20.
    Haws MJ, Kucan JO, Roth AC et al (1996) The effects of chronic ketorolac tromethamine (toradol) on wound healing. Ann Plast Surg 37:147–151PubMedCrossRefGoogle Scholar
  21. 21.
    Henry M, Arnold T, Harvey J (2003) BTS guidelines for the management of spontaneous pneumothorax. Thorax 58(suppl II):ii39–ii52PubMedGoogle Scholar
  22. 22.
    Ingolfsson I, Gyllstedt E, Lillo-Gil R et al (2006) Reoperations are common following VATS for spontaneous pneumothorax: study of risk factors. Interact Cardiovasc Thorac Surg 5:602–607PubMedCrossRefGoogle Scholar
  23. 23.
    Jimenez-Merchan R, Garcia-Diaz F, Arenas Linares C et al (1997) Comparative retrospective study of surgical treatment of spontaneous pneumothorax. Thoracotomy vs thoracoscopy. Surg Endosc 11:919–922PubMedCrossRefGoogle Scholar
  24. 24.
    Kim KH, Kim HK, Han JY et al (1996) Transaxillary minithoracotomy versus video-assisted thoracic surgery for spontaneous pneumothorax. Ann Thorac Surg 61:1510–1512PubMedCrossRefGoogle Scholar
  25. 25.
    Lang-Lazdunski L, Chapuis O, Bonnet PM et al (2003) Videothoracoscopic bleb excision and pleural abrasion for the treatment of primary spontaneous pneumothorax: long-term results. Ann Thorac Surg 75:960–965PubMedCrossRefGoogle Scholar
  26. 26.
    Lardinois D, Vogt P, Yang L et al (2004) Non-steroidal anti-inflammatory drugs decrease the quality of pleurodesis after mechanical pleural abrasion. Eur J Cardiothorac Surg 25:865–871PubMedCrossRefGoogle Scholar
  27. 27.
    Lee YC, Malkerneker D, Devin CJ et al (2001) Comparing transforming growth factor beta2 and fibronectin as pleurodesing agents. Respirology 6:281–286PubMedCrossRefGoogle Scholar
  28. 28.
    Leo F, Pastorino U, Goldstraw P (2000) Pleurectomy in primary pneumothorax: is extensive pleurectomy necessary? J Cardiovasc Surg (Torino) 41:633–636Google Scholar
  29. 29.
    Li ZJ, Zhang Y, Fu T et al (2006) Evaluation of curative effects of axillary thoracotomy and videothoracoscopy in treatment for primary spontaneous pneumothorax. J Jilin Univ Med Ed 32:711–713Google Scholar
  30. 30.
    Maier A, Anegg U, Renner H et al (2000) Four-year experience with pleural abrasion using a rotating brush during video-assisted thoracoscopy. Surg Endosc 14:75–78PubMedCrossRefGoogle Scholar
  31. 31.
    Massard G, Thomas P, Wihlm JM (1998) Minimally invasive management for first and recurrent pneumothorax. Ann Thorac Surg 66:592–599PubMedCrossRefGoogle Scholar
  32. 32.
    Matsuzoe D, Iwasaki A, Okabayashi K et al (1999) Recurrence after thoracoscopic surgery for spontaneous pneumothorax. Int Surg 84:111–114PubMedGoogle Scholar
  33. 33.
    Nkere UU, Griffin SC, Fountain SW (1991) Pleural abrasion. A new method for pleurodesis. Thorax 46:596–598PubMedCrossRefGoogle Scholar
  34. 34.
    Treasure T (2007) Minimally invasive surgery for pneumothorax: the evidence, changing practice and current opinion. J R Soc Med 100:419–422Google Scholar
  35. 35.
    Passlick B, Born C, Thetter O (1997) Results of video-assisted thoracic surgery (VATS) in patients with recurrent or persisting primary spontaneous pneumothorax. Pneumologie 51:1135–1139PubMedGoogle Scholar
  36. 36.
    Perez RL, Roman J (1995) Fibrin enhances the expression of IL-1 beta by human peripheral blood mononuclear cells. Implications in pulmonary inflammation. J Immunol 154:1879–1887PubMedGoogle Scholar
  37. 37.
    Rena O, Massera F, Papalia E et al (2008) Surgical pleurodesis for Vanderschueren’s stage III primary spontaneous pneumothorax. Eur Respir J 31:837–841PubMedCrossRefGoogle Scholar
  38. 38.
    Sawada S, Watanabe Y, Moriyama S (2005) Video-assisted thoracoscopic surgery for spontaneous pneumothorax: evaluation of indications and long-term outcome compared with conservative treatment and open thoracotomy. Chest 127:2226–2230PubMedCrossRefGoogle Scholar
  39. 39.
    Sing SV (1982) The surgical treatment of spontaneous pneumothorax by partial pleurectomy. Scand J Thorac Cardiovasc Surg 16:75CrossRefGoogle Scholar
  40. 40.
    Thomas P, Le Mee F, Le Hors H et al (1993) Results of surgical treatment of recurrent pneumothorax. Ann Chir 47:136–140PubMedGoogle Scholar
  41. 41.
    Tschopp JM, Rami-Porta R, Noppen M et al (2006) Management of spontaneous pneumothorax: state of the art. Eur Respir J 28:637–650PubMedCrossRefGoogle Scholar
  42. 42.
    Tyson MD, Crandall WB (1941) The surgical treatment of recurrent idiopathic spontaneous pneumothorax. J Thorac Surg 10:566Google Scholar
  43. 43.
    Viskum K, Lange P, Mortenson J (1989) Long-term sequelae after talc pleurodesis for spontaneous pneumothorax. Pneumologie 43:105–106PubMedGoogle Scholar
  44. 44.
    Waller DA, Forty J, Morritt GN (1994) Video-assisted thoracoscopic surgery versus thoracotomy for spontaneous pneumothorax. Ann Thorac Surg 58:372–376PubMedCrossRefGoogle Scholar
  45. 45.
    Waller D (1999) Video-assisted thoracoscopic surgery for spontaneous pneumothorax: a 7-year learning experience. Ann R Coll Surg Engl 81:1387–1392Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Uliano Morandi
    • 1
    Email author
  • Alessandro Stefani
    • 1
  • Christian Casali
    • 1
  1. 1.Division of Thoracic Surgery, Department of General Surgery and Surgical SpecialtiesUniversity of Modena and Reggio Emilia, Policlinico of ModenaModenaItaly

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