Pleurodesis with a 50% Glucose Solution in Patients with Spontaneous Pneumothorax in Whom an Operation is Contraindicated

Abstract

PURPOSE: Pleurodesis continues to play a central role in the management of pneumothorax. In our institute, a 50% glucose solution is used for pleurodesis. We retrospectively analysed the treatment effects of pleurodesis in patients with spontaneous pneumothorax in whom an operation was contraindicated because of underlying disease. METHODS: 13 patients (18 cases) with spontaneous pneumothorax were treated with pleurodesis with a 50% glucose solution. After local anesthesia of parietal pleura, 200 to500 mL of a 50% glucose solution was instilled into the pleural space. Pleurodesis was repeated two or three times, until the air leakage stopped. RESULTS: Air leakage stopped in all cases and there were no treatment-related deaths.Overall survival rates at 1, 2, and 3 years after treatment were 83%, 74%, and 49%, respectively. Post-treatment recurrence was observed in six cases. Four cases of recurrence were treated with pleurodesis with a 50% glucose solution. All cases of recurrence occurred within 3 months after pleurodesis. CONCLUSION: Pleurodesis with a 50% glucose solution is effective and safe in patients with pneumothorax. This procedure can be performed in patients with recurrent pneumothorax as well as patients with a first episode of pneumothorax in whom prolonged air leakage is predicted.