Advertisement

General Thoracic and Cardiovascular Surgery

, Volume 58, Issue 3, pp 113–119 | Cite as

Latest treatments for spontaneous pneumothorax

  • Masatoshi KuriharaEmail author
  • Hideyuki Kataoka
  • Aki Ishikawa
  • Reina Endo
Current Topics Review Ariticle

Abstract

Objective

Currently, the treatment of pneumothorax varies among hospitals. Three factors account for the differences. First, pneumothorax expresses the state of disease instead of the disease itself. Some pneumothoraces heal on their own but patients with pneumothorax due to chronic diseases may need further intervention. The decision for the choice of treatment is up to the physician. Second, it is insufficient to treat pneumothorax with current treatment guidelines. Third, prognosis and follow-up after pneumothorax treatment is not well documented. Therefore, verification/assessment of treatment and its effect is insufficient.

Methods

To prevent postoperative bulla neogenesis, the “covering technique” is most effective. Chemical pleurodesis has shown a great number of recurrences and has led to inconveniences, such as various results among individuals. Therefore, it should not be the recommended therapy.

Results and conclusion

Intractable pneumothorax in elderly patients has been increasing year after year. Interventional treatments such as endobronchial Watanabe spigot embolization and the thoracographic fibrin glue sealing method are expected to become more common in the future, keeping some patients from undergoing surgery. Causes are still unknown for certain pneumothoraces in women, and there are still numerous cases of postoperative recurrence among young males. Further studies in this field are expected in future.

Key words

Pneumothorax Thoracoscopic surgery Bullae neogenesis Covering technique Interventional radiotherapy 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    JATS. Annual statistics 2006. Japanese Association for Thoracic Surgery, 2006.Google Scholar
  2. 2.
    Baumann MH, Strange C, Heffner JE, Light R, Kirby TJ, Klein J, et al. Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement. Chest 2001;119:590–602.CrossRefPubMedGoogle Scholar
  3. 3.
    Miller AC, Harvey JE. Guidelines for the management of spontaneous pneumothorax: Standards of Care Committee, British Thoracic Society. BMJ 1993;307:114–116.CrossRefPubMedGoogle Scholar
  4. 4.
    JSPCLD. Guidelines for pneumothorax treatment: The Japan Society for Pneumothorax and Cystic Lung Diseases. 2nd edn. In: Guidelines Committee. Tokyo: Kanehara; 2009. p. 44–47.Google Scholar
  5. 5.
    Kurihara M. Strategy of primary and secondary spontaneous pneumothorax treatment (postgraduate course). Presented at the 60th annual meeting of the Japanese Association for Thoracic Surgery 2007. p. 96–103.Google Scholar
  6. 6.
    Naunheim KS, Mack MJ, Hazelrigg SR, Ferguson MK, Ferson PF, Boley TM, et al. Safety and efficacy of videoassisted thoracic surgical techniques for the treatment of spontaneous pneumothorax. J Thorac Cardiovasc Surg 1995;109:1198–1203; discussion 1203–4.CrossRefPubMedGoogle Scholar
  7. 7.
    Ohno K, Miyoshi S, Minami M, Akashi A, Maeda H, Nakagawa K, et al. Ipsilateral recurrence frequency after video-assisted thoracoscopic surgery for primary spontaneous pneumothorax Jpn J Thorac Cardiovasc Surg 2000;48:757–760.PubMedGoogle Scholar
  8. 8.
    Sawada S, Watanabe Y, Moriyama S. Video-assisted thoracoscopic surgery for primary spontaneous pneumothorax: evaluation of indications and long-term outcome compared with conservative treatment and open thoracotomy. Chest 2005;127:2226–2230.CrossRefPubMedGoogle Scholar
  9. 9.
    Horio H, Nomori H, Kobayashi R, Naruke T, Suematsu K. Impact of additional pleurodesis in video-assisted thoracoscopic bullectomy for primary spontaneous pneumothorax. Surg Endosc 2002;6:630–634.Google Scholar
  10. 10.
    Kurihara M, Isaka Y, Takeno Y. The results of thoracoscopic surgery for spontaneous pneumothorax. J Jpn Soc Endosc Surg 1997;2:185–190.Google Scholar
  11. 11.
    Sakamoto K, Takei H, Nishii T, Maehara T, Omori T, Tajiri M, et al. Staple line coverage with absorbable mesh after thoracoscopic bullectomy for spontaneous pneumothorax. Surg Endosc 2004;18:478–481.CrossRefPubMedGoogle Scholar
  12. 12.
    Doherty P, Greene L, Sanchez M. Thoracoscopic management of primary spontaneous pneumothorax. Am Surg 2006;72:145–149.Google Scholar
  13. 13.
    Casadio C, Rena O, Giobbe R, Rigoni R, Maggi G, Ooliaro A, et al. Stapler blebectomy and pleural abrasion by videoassisted thoracoscopy for spontaneous pneumothorax. J Cardiovasc Surg 2002;43:259–262.Google Scholar
  14. 14.
    Hattori H, Kurihara M, Takeno Y. Management of recurrence after thoracoscopic surgery for sponataneous pneumothorax. J Jpn Soc Pneumothorax Cystic Lung Dis 1999;58–60.Google Scholar
  15. 15.
    Uomoto M, Hathisuka Y, Kataoka M, Kawamata O, Hayashi D, Inoue F. Usefulness of Tissue link in surgery for lung bullae: the results of multi-institutional clinical study. J Jpn Assoc Chest Surg 2008;22:135–141.CrossRefGoogle Scholar
  16. 16.
    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). Presented at the LAM Symposium, Cincinnati, OH, 2008.Google Scholar
  17. 17.
    Takeno Y, Ozawa S, Kurihara M, Tagaya E. Clinics on pneumothorax. Innervision 1992;7:11–32.Google Scholar
  18. 18.
    Watanabe Y, Matsuo K, Tamaoki, A, Komoto R, Hiraki S. Bronchial occlusion with endobronchial Watanabe spigot. J Bronchol 2003;10:264–267.CrossRefGoogle Scholar
  19. 19.
    Kurihara M, Shimatani S. Thoracographic fibrin glue sealing method. Jpn J Chest Surg 2004;18:330.Google Scholar
  20. 20.
    Kurihara M, Kataoka H, Yashiro T. Interventional radiotherapy for intractable pneumothorax (thoracographic fibrin glue sealing method: TGF) Jpn J Thorac Cardiovasc Surg 2004;52(suppl):253.Google Scholar
  21. 21.
    Katsuno G, Tsumura M, Kokudo Y. Postoperative recurrence after VATS for spontaneous pneumothorax. J Jpn Surg Assoc 2003;64:2378–2383.Google Scholar
  22. 22.
    Thoracographic fibrin glue sealing method. 2008.Google Scholar
  23. 23.
    Glen A, Sidney P, Georgea A. Catamenial pneumothorax. JAMA 1972;219:1328–1332.CrossRefGoogle Scholar
  24. 24.
    Maurer E, Schaal J, Medenes F. Chronic recurring spontaneous pneumothorax due to endometriosis of the diaphragm. JAMA 1958;201:2013–2014.Google Scholar
  25. 25.
    Slasky BS, Siewers RD, Lecky JW, Zajko A, Burkholder JA. Catamenial pneumothorax: the roles of diaphragmatic defects and endometriosis. AJR Am J Roentgenol 1982;138:639–643.PubMedGoogle Scholar
  26. 26.
    Almoosa KF, Ryu JH, Mendez J, Huggins JT, Young LR, Sullivan EJ, et al. Management of pneumothorax in lymphangioleiomyomatosis: effects on recurrence and lung transplantation complications. Chest 2006;129:1274–1281.CrossRefPubMedGoogle Scholar
  27. 27.
    Ryu JH, Moss J, Beck GJ, Lee JC, Brown KK, Chapman JT, et al. The NHLBI Lymphangioleiomyomatosis Registry: characteristics of 230 patients at enrollment. Am J Respir Crit Care Med 2006;173:105–111.CrossRefPubMedGoogle Scholar
  28. 28.
    Kpodonu J, Massad MG, Chaer RA, Caines A, Evans A, Snow NJ, et al. The US experience with lung transplantation for pulmonary lymphangioleiomyomatosis. J Heart Lung Transplant 2005;24:1247–1253.CrossRefPubMedGoogle Scholar
  29. 29.
    Kurihara M, Kataoka H, Ebana H. Thoracoscopic surgery for recurrent pneumothorax in LAM patients requiring lung transplantation in the future (total pleural covering method). Jpn J Thorac Cardiovasc Surg 2006;54(suppl):274.Google Scholar
  30. 30.
    Ozcan C, McGahren ED, Rodgers BM. Thoracoscopic treatment of spontaneous pneumothorax in children. J Pediatr Surg 2003;38:1459–1464.CrossRefPubMedGoogle Scholar
  31. 31.
    Qureshi FG, Sandulache VC, Richardson W, Ergun O, Ford HR, Hackam DJ. Primary vs delayed surgery for spontaneous pneumothorax in children: which is better? J Pediatr Surg 2005;40:166–169.CrossRefPubMedGoogle Scholar
  32. 32.
    Birt AR, Hogg GR, Dube WJ. Hereditary multiple fibrofolliculomas with trichodiscomas and acrochordons. Arch Dermatol 1977;113:1674–1677.CrossRefPubMedGoogle Scholar
  33. 33.
    Souza CA, Finley R, Muller NL. Birt-Hogg-Dube syndrome: a rare cause of pulmonary cysts. AJR Am J Roentgenol 2005;185:1237–1239.CrossRefPubMedGoogle Scholar

Copyright information

© The Japanese Association for Thoracic Surgery 2010

Authors and Affiliations

  • Masatoshi Kurihara
    • 1
    Email author
  • Hideyuki Kataoka
    • 1
  • Aki Ishikawa
    • 1
  • Reina Endo
    • 1
  1. 1.Pneumothorax Research Center and Thoracic Surgery DivisionNissan Tamagawa HospitalTokyoJapan

Personalised recommendations