초록접수 현황
| 15F-252 | 포럼 발표 |
The Management of Chemical Pleurodesis with Viscum Album in Patients with Persistent Air Leakage
Jae Bum Park, Jae Joon Hwang, Song Am Lee, Woo Surng Lee, Yo Han Kim
Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
Background : Persistent air leak after major pulmonary resection or involved with secondary lung disease is prevalent and associated with significant morbidity. Chemical pleurodesis is a practical therapeutic tool to manage the patients with persistent air leak. Many sclerosing agents such as anti-neoplastics, tetracycline derivatives, erythromycin and talc have been instilled into pleural cavity to create pleurodesis. Among these various substances, viscum album (fraxini) is considered effective and safe. The aim of this study was to evaluate the efficacy and safety of viscum album pleurodesis in patients with intractable prolonged air leakage.
Methods : Between February 2013 and February 2015, 73 consecutive patients who underwent pleurodesis due to persistent air leak were enrolled in this study. The 49 patients received viscum album due to continuous air leak after major pulmonary resection surgery, otherwise 24 patients performed chemical pleurodesis for refractory air leak with underlying lung disease such as COPD and pulmonary tuberculosis. Pleurodesis was performed using 100 mg of viscum album (fraxini) at one time through the indwelling chest tube. Main studied outcomes were focused on success rate of pleurodesis assessed on chest radiography and cessation of the air leak after procedure. Other side effects or complications such as pain, fever and respiratory problems were also evaluated.
Results : The study population was predominantly male (n=64, 87.6%). The patient age ranged from 17 to 85 years (mean age of 53.3±20.7). The overall success rate was 90.4%. One patient died of pneumonia not related to the viscum album pleurodesis. The mean length of stoppage to air leakage was 28.00 ± 22.19 hours. The mean duration of chest tube drainage after pleurodesis was 2.78 ± 1.35 days. The mean number of pleurodesis was 1.38 ± 0.75. Temporary fevers over 38.0°C were observed in 12 patients (16.4%). 36patients (49.3%) complained of chest pain requiring a prescription for pain control. No other respiratory difficulties were observed in all patients. There were no major complications or mortalities due to the application of viscum album pleurodesis.
Conclusion : Air leaks remain an important cause of morbidity. This viscum album pleurodesis could be considered as an option for the treatment of prolonged air leak patients, associated with acceptable side effects
Methods : Between February 2013 and February 2015, 73 consecutive patients who underwent pleurodesis due to persistent air leak were enrolled in this study. The 49 patients received viscum album due to continuous air leak after major pulmonary resection surgery, otherwise 24 patients performed chemical pleurodesis for refractory air leak with underlying lung disease such as COPD and pulmonary tuberculosis. Pleurodesis was performed using 100 mg of viscum album (fraxini) at one time through the indwelling chest tube. Main studied outcomes were focused on success rate of pleurodesis assessed on chest radiography and cessation of the air leak after procedure. Other side effects or complications such as pain, fever and respiratory problems were also evaluated.
Results : The study population was predominantly male (n=64, 87.6%). The patient age ranged from 17 to 85 years (mean age of 53.3±20.7). The overall success rate was 90.4%. One patient died of pneumonia not related to the viscum album pleurodesis. The mean length of stoppage to air leakage was 28.00 ± 22.19 hours. The mean duration of chest tube drainage after pleurodesis was 2.78 ± 1.35 days. The mean number of pleurodesis was 1.38 ± 0.75. Temporary fevers over 38.0°C were observed in 12 patients (16.4%). 36patients (49.3%) complained of chest pain requiring a prescription for pain control. No other respiratory difficulties were observed in all patients. There were no major complications or mortalities due to the application of viscum album pleurodesis.
Conclusion : Air leaks remain an important cause of morbidity. This viscum album pleurodesis could be considered as an option for the treatment of prolonged air leak patients, associated with acceptable side effects
책임저자: Jae Joon Hwang
Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
연락처 : Jae Bum Park, Tel: 010-2519-7487 , E-mail : 20090048@kuh.ac.kr
