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Effectiveness of chemical pleurodesis in spontaneous pneumothorax recurrence prevention: a systematic review
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  • Published on: 28 February 2018
    Pleural sclerosis vs pleurodesis

    AMENDED

    Dear Sir,
    In this comprehensive article the authors state that "recurrence prevention involves an attempt at pleurodesis
    ( permanent apposition of the visceral and parietal pleura to seal the pleural space )"
    This is a simple and convincing explanation for any young male suffering persistent or recurrent pneumothorax (or indeed, a patient suffering symptomatic malignant pleural effusion ).
    The histological changes after "pleurodesis" have been widely and clearly described in the literature and universally accepted. ie. fibrin deposition, collagen formation , fibrosis +/- some adhesions.
    However the medical literature seems devoid of descriptions of ablation of the oleural cavity following "successful pleurodesis", at subsequent thoracotomy or post mortem despite the enormous number of such procedures performed since the 1930s.
    This must raise the possibility that such ablation does not occur and that the "clinical success" of the procedure results from the histological changes which are described.
    Are the authors aware of any evidence to support ablation/obliteration of the pleural cavity following this procedure ? Perhaps pleurosclerosis may be a more accurate term

    Conflict of Interest:
    None declared.