Effects of different exhaust modes on spontaneous pneumothorax with pleural adhesion

Abstract

Objective To investigate the effects of the frequency of spontaneous pneumothorax and different exhaust modes on the incidence of pleural adhesion.Methods Thoracic or video-assisted thoracic surgery treatments of idiopathic spontaneous pneumothorax were analyzed retrospectively.According to the previous treatments of the spontaneous pneumothorax before surgery,the patients were divided into three groups:non-exhaust air group,thoracentesis degassing group,and closed thoracic drainage group.The relationship of occurrence of pleural adhesion with the frequency of spontaneous pneumothorax and different treatments was observed.Results Of a total of 504 patients in the three groups,the incidence of pleural adhesion in non-exhaust air group (n =91),thoracentesis degassing group (n =58),and closed thoracic drainage group (n =355) was 48.35 ％,65.52 ％,and 78.03 ％,respectively,showing successive increase (x2=32.172,P ＜0.05).In the non-exhaust air group,for patients who had suffered from spontaneous pneumothorax once (n =45),twice (n =26),and no less than three times (n =20),the incidence of pleural adhesion was 37.78％,46.15％,and 75.00％,respectively,showing the incidence of pleural adhesion increased as the frequency of spontaneous pneumothorax increased (x2 =7.752,P ＜ 0.05).In the thoracentesis degassing group,for patients operated thoracentesis degassing once (n =42) and twice (n =16),the incidence of pleural adhesion was 59.52％ and 93.75％,respectively.In the closed thoracic drainage group,for patients operated the closed thoracic drainage once (n =191),twice (n =108),and no less than three times (n =56),the incidence of pleural adhesion was 71.20％,81.48％,and 94.64％,respectively.The incidence of pleural adhesion increased as the frequency of thoracentesis degassing and closed thoracic drainage increased (P ＜0.05).Conclusions High recurrence rate of pleural adhesion is due to thoracentesis degassing and closed thoracic drainage for the treatment of spontaneous pneumothorax.The higher recurrence rate of pneumothorax coupled with higher frequency of traumatic air drainage therapy,the higher incidence of pleural adhesion,leading to difficulty in treating recurrent pneumothorax and higher risks of medical complications. Key words: Spontaneous pneumothorax; Exhaust mode; Pleural adhesion