Management and prevention of spontaneous pneumothorax using pleurodesis in Hong Kong
DESIGN: A retrospective multicentre analysis of patients admitted to 12 hospitals in Hong Kong with SP in 2004 and who subsequently underwent pleurodesis for the same episode.
RESULTS: Pleurodesis was performed in 394 episodes. Initial medical chemical pleurodesis was performed for 258 (65.5%) patients (‘initial medical group’), while 136 (34.5%) underwent initial surgical pleurodesis (‘initial surgical group’). Secondary spontaneous pneumothorax (SSP; 237 episodes, 60.2%) was the most common indication for pleurodesis; it was also performed after a first episode of primary spontaneous pneumothorax (PSP) in 22 episodes (5.6%). Tetracycline derivatives (172 episodes, 66.7%) were the most popular sclerosing agents in the initial medical group. Those in the initial medical group were older and were more likely to be males, have SSP, chronic obstructive pulmonary disease and a history of past pleurodesis (P < 0.05) compared to the initial surgical group. Compared to the tetracycline group, more patients who initially received talc slurry had the procedure performed by surgeons, had larger (≥2 cm) pneumothorax or required suction during initial drainage (P < 0.05).
CONCLUSIONS: Despite the availability of international guidelines, there is considerable variation in pleurodesis for SP.
Keywords: pleurodesis; spontaneous pneumothorax; talc; tetracycline; thoracoscopy
Document Type: Regular Paper
Affiliations: 1: Department of Medicine, Queen Elizabeth Hospital, Hong Kong, SAR China 2: Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong, SAR China 3: Department of Medicine, Ruttonjee and Tang Shiu Kin Hospital, Hong Kong, SAR China 4: Department of Medicine, Kwong Wah Hospital, Hong Kong, SAR China 5: Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, SAR China 6: Department of Medicine, Queen Mary Hospital, Hong Kong, SAR China 7: Department of Medicine, Caritas Medical Centre, Hong Kong, SAR China 8: Department of Medicine, North District Hospital, Hong Kong, SAR China 9: Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, SAR China 10: Department of Medicine, Tseung Kwan O Hospital, Hong Kong, SAR China 11: Respiratory Medical Department, Grantham Hospital, Hong Kong, SAR China 12: Department of Cardiothoracic Surgery, Queen Elizabeth Hospital, Hong Kong, SAR China 13: Department of Medicine, Princess Margaret Hospital, Hong Kong, SAR China
Publication date: 01 March 2011
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