Subpleural Thoracoscopic Application of Fibrin Glue in Pneumothorax

  • P. L. Bölcskei
  • M. Wagner

Abstract

Acute therapy with a vacuum pump in primary manifestations of spontaneous pneumothorax provides successful long-term results in about 70% of cases. Therefore it is the opinion of most authors that primary thoracotomy without previous diagnostic differentiation is not indicated. For an optimal therapy diagnostic procedures must give a clear picture of the structure of lung and pleura in the first days of the drainage therapy. In 70% of our patients there was only a solitary bulla or a small group of bullae as the probable cause of pneumothorax. We applied fibrin glue into these solitary bullae with a maximal diameter of 2.5 cm by thoracoscopy using a modified Schiessle needle. Up to now we have treated 40 patients in this way. This therapy excludes the possibility that the bulla will cause a new pneumothorax and furthermore avoids harmful injuries of the pleura visceralis, thus reducing the risk of producing new pleuropleural adhesions or persistent bronchopleural fistula. Of these 40 patients 7 had been operated on because of additional pleuropleural adhesions within large blood vessels or persistent bronchopleural fistula. The other patients without operation who were treated with subpleural fibrin have been free of recurrence for 1–54 months. They are being followed up by adjusted diagnostic means to assess the long-term results.

Keywords

Catheter Dioxid Pneumothorax 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • P. L. Bölcskei
  • M. Wagner

There are no affiliations available

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