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Autoblood Plus OK432 Pleurodesis With Open Drainage for Persistent Air Leak After Lobectomy

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Abstract

Prolonged air leak with dead space after lobectomy was successfully treated with autoblood plus OK432 pleurodesis in 10 patients. We tried this method for the purpose of (1) reduction of dead space and (2) effective chemical sclerosis. This easy method was associated with acceptable side effects and should be considered as an option for the treatment of prolonged air leak after lobectomy, especially with dead space.

Section snippets

Patients and Methods

From January 1996 to February 1997, 10 consecutive patients who underwent lobectomy for lung cancer were treated by blood OK432 pleurodesis because of persistent air leakage (Table 1). In all cases, we tried several procedures (decreasing, increasing, or stopping chest suction) before pleurodesis. In principle, patients with persistent air leak longer than 1 week (8.7 ± 4.7 days) were treated. In 4 patients, prior therapies (tetracycline, OK432, and another pleurodesis) were tried but failed.

Results

Blood OK432 pleurodesis was done once in 6 patients and twice in 4 patients (see Table 1). In all patients, successful treatment of the air leak was achieved within few days (mean, 3.8 ± 2.0 days). The air leak actually stopped 1 to 2 days after pleurodesis in most patients. The chest tube was removed 1 to 2 days after the confirmation of no air leak. No major side effects were observed. In 5 patients, fever of less than 38°C was observed.

In patient 1, presented as an example, obliteration of

Comment

Air leak after lobectomy usually ceases spontaneously if adequate reexpansion of the remaining lung is established. Even if a prolonged air leak occurs, pleurodesis with sclerosing agents such as tetracycline, talc, or OK432 may work 1, 2, 3. However, chemical pleurodesis often fails to work if persistent air leak with dead space remains. Furthermore, without adequate reexpansion, the sclerosing agent itself may prevent reexpansion of the remaining lung because of thickening of the visceral

References (5)

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