Effects of Additional Minocycline Pleurodesis after Thoracoscopic Procedures for Primary Spontaneous Pneumothorax

Jin Shing Chen, Hsao Hsun Hsu, Shuenn Wen Kuo, Pi Ru Tsai, Robert J. Chen, Jang Ming Lee, Yung Chie Lee

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Study objectives: To evaluate the safety and efficacy of additional minocycline pleurodesis after thoracoscopic treatment of primary spontaneous pneumothorax. Design: Retrospective comparative study with a historical control. Setting: Thoracic surgical division of a university-affiliated tertiary medical center. Patients and methods: Between April 1994 and April 2001, 313 consecutive patients (minocycline group) with primary spontaneous pneumothorax were treated by video-assisted thoracoscopic surgery. The procedures included resection of the blebs and mechanical pleurodesis by scrubbing the parietal pleura. After operation, minocycline hydrochloride, 7 mg/kg, was instilled into the pleural space through a thoracostomy tube. The control group consisted of 51 consecutive patients who underwent the same thoracoscopic procedures alone for primary spontaneous pneumothorax between January 1992 and April 1994. Results: There was no significant difference between the two groups in terms of demographic data, operative findings, and operation time. Chest pain was a common complaint after minocycline pleurodesis, but the total doses of requested analgesics were comparable in both groups. The rate of prolonged air leaks was significantly lower in the minocycline group (7.0% vs 17.6%, p = 0.025). Patients treated with minocycline had shorter periods of postoperative chest drainage and hospitalization. The ipsilateral recurrence rate was also significantly lower in these patients (2.9% vs 9.8%, p = 0.033). Conclusions: Minocycline pleurodesis is a safe and convenient procedure that may improve the outcome and reduce the rate of recurrence after thoracoscopic treatment for primary spontaneous pneumothorax. A randomized control study may be needed to confirm the findings.

Original languageEnglish
Pages (from-to)50-55
Number of pages6
JournalChest
Volume125
Issue number1
DOIs
Publication statusPublished - Jan 1 2004
Externally publishedYes

Fingerprint

Pleurodesis
Minocycline
Pneumothorax
Thorax
Thoracostomy
Video-Assisted Thoracic Surgery
Recurrence
Pleura
Blister
Primary Spontaneous Pneumothorax
Chest Pain
Postoperative Period
Analgesics
Drainage
Hospitalization
Retrospective Studies
Air
Demography
Safety
Control Groups

Keywords

  • Minocycline
  • Pleurodesis
  • Primary spontaneous pneumothorax
  • Thoracoscopy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Effects of Additional Minocycline Pleurodesis after Thoracoscopic Procedures for Primary Spontaneous Pneumothorax. / Chen, Jin Shing; Hsu, Hsao Hsun; Kuo, Shuenn Wen; Tsai, Pi Ru; Chen, Robert J.; Lee, Jang Ming; Lee, Yung Chie.

In: Chest, Vol. 125, No. 1, 01.01.2004, p. 50-55.

Research output: Contribution to journalArticle

Chen, Jin Shing ; Hsu, Hsao Hsun ; Kuo, Shuenn Wen ; Tsai, Pi Ru ; Chen, Robert J. ; Lee, Jang Ming ; Lee, Yung Chie. / Effects of Additional Minocycline Pleurodesis after Thoracoscopic Procedures for Primary Spontaneous Pneumothorax. In: Chest. 2004 ; Vol. 125, No. 1. pp. 50-55.
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N2 - Study objectives: To evaluate the safety and efficacy of additional minocycline pleurodesis after thoracoscopic treatment of primary spontaneous pneumothorax. Design: Retrospective comparative study with a historical control. Setting: Thoracic surgical division of a university-affiliated tertiary medical center. Patients and methods: Between April 1994 and April 2001, 313 consecutive patients (minocycline group) with primary spontaneous pneumothorax were treated by video-assisted thoracoscopic surgery. The procedures included resection of the blebs and mechanical pleurodesis by scrubbing the parietal pleura. After operation, minocycline hydrochloride, 7 mg/kg, was instilled into the pleural space through a thoracostomy tube. The control group consisted of 51 consecutive patients who underwent the same thoracoscopic procedures alone for primary spontaneous pneumothorax between January 1992 and April 1994. Results: There was no significant difference between the two groups in terms of demographic data, operative findings, and operation time. Chest pain was a common complaint after minocycline pleurodesis, but the total doses of requested analgesics were comparable in both groups. The rate of prolonged air leaks was significantly lower in the minocycline group (7.0% vs 17.6%, p = 0.025). Patients treated with minocycline had shorter periods of postoperative chest drainage and hospitalization. The ipsilateral recurrence rate was also significantly lower in these patients (2.9% vs 9.8%, p = 0.033). Conclusions: Minocycline pleurodesis is a safe and convenient procedure that may improve the outcome and reduce the rate of recurrence after thoracoscopic treatment for primary spontaneous pneumothorax. A randomized control study may be needed to confirm the findings.

AB - Study objectives: To evaluate the safety and efficacy of additional minocycline pleurodesis after thoracoscopic treatment of primary spontaneous pneumothorax. Design: Retrospective comparative study with a historical control. Setting: Thoracic surgical division of a university-affiliated tertiary medical center. Patients and methods: Between April 1994 and April 2001, 313 consecutive patients (minocycline group) with primary spontaneous pneumothorax were treated by video-assisted thoracoscopic surgery. The procedures included resection of the blebs and mechanical pleurodesis by scrubbing the parietal pleura. After operation, minocycline hydrochloride, 7 mg/kg, was instilled into the pleural space through a thoracostomy tube. The control group consisted of 51 consecutive patients who underwent the same thoracoscopic procedures alone for primary spontaneous pneumothorax between January 1992 and April 1994. Results: There was no significant difference between the two groups in terms of demographic data, operative findings, and operation time. Chest pain was a common complaint after minocycline pleurodesis, but the total doses of requested analgesics were comparable in both groups. The rate of prolonged air leaks was significantly lower in the minocycline group (7.0% vs 17.6%, p = 0.025). Patients treated with minocycline had shorter periods of postoperative chest drainage and hospitalization. The ipsilateral recurrence rate was also significantly lower in these patients (2.9% vs 9.8%, p = 0.033). Conclusions: Minocycline pleurodesis is a safe and convenient procedure that may improve the outcome and reduce the rate of recurrence after thoracoscopic treatment for primary spontaneous pneumothorax. A randomized control study may be needed to confirm the findings.

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