Pneumothorax
Conditions
Keywords
Video-Assisted Thoracoscopic Surgery, Spontaneous pneumothorax, Pleurectomy, Pleural abrasion, Minocycline
Brief summary
Optimal surgical management of primary spontaneous pneumothorax has been a matter of devate, especially regarding the method of pleurodesis. Previous studies have shown that thoracoscopic apical pleurectomy is a reliable method with a very low incidence of recurrence. However, this procedure is more technical demanding and time consuming through thoracoscopy. In addition, a more extensive pleural injury may cause impaired pulmonary function and a higher risk of perioperative complication such as hemothorax. In our previous studies, we have shown that thoracoscopic pleural abrasion with minocycline instillation is an easy and convinent method of pleurodesis which decreases the rate of recurrence without affecting pulmonary function. In this study, we hypothesized that pleural abrasion with minocycline instillation is as effective as apical pleurectomy in preventing pneumothorax recurrence while the short-term and long-term complications are less.
Detailed description
Optimal surgical management of primary spontaneous pneumothorax has been a matter of devate, especially regarding the method of pleurodesis. Previous studies have shown that thoracoscopic apical pleurectomy is a reliable method with a very low incidence of recurrence. However, this procedure is more technical demanding and time consuming through thoracoscopy. In addition, a more extensive pleural injury may cause impaired pulmonary function and a higher risk of perioperative complication such as hemothorax. In our previous studies, we have shown that thoracoscopic pleural abrasion with minocycline instillation is an easy and convinent method of pleurodesis which decreases the rate of recurrence without affecting pulmonary function. In this study, we hypothesized that pleural abrasion with minocycline instillation is as effective as apical pleurectomy in preventing pneumothorax recurrence while the short-term and long-term complications are less.
Interventions
PROCEDURE1 apical pleurectomy
PROCEDURE2 pleural abrasion + minocycline pleurodesis
Sponsors
National Science and Technology Council, Taiwan
National Taiwan University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
15 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* Age between 15 and 50 years old Undergoing thoracoscopic bullectomy Had multiple blebs or no identified blebs during the operation
Exclusion criteria
* With underlying pulmonary disease With major systemic disease or acute infection Underwent ipsilateral operation previously Bleb number = 1 or 2
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Recurrence rate of pneumothorax after thoracoscopic operation. | — |
Secondary
| Measure | Time frame |
|---|---|
| The short-term results (Pain level, chest tube duration, hospital stay, etc) | — |
| Complication rate | — |
| Long-term results: residual pain | — |
| Long-term pulmonary function test | — |
Countries
Taiwan
Contacts
Primary ContactYung-Chie Lee, MD, PhD
Backup ContactJin-Shing Chen, MD, PhD
Outcome results
None listed