Abstract
PurposePleurodesis is performed in patients demonstrating air leakage after lung resection and in those with pneumothorax who must avoid surgery. However, there have so far been very few reports of pleurodesis with 50 % glucose. We herein examined the feasibility and effectiveness of this novel pleurodesis technique.MethodsThirty-five patients after lung resection and 11 pneumothorax patients without surgery were treated with pleurodesis using 50 % glucose. Approximately, 200 mL of 50 % glucose solution was injected into the pleural space and repeated until the air leakage stopped. Cases in which the air leakage did not stop after three injections were considered to be unsuccessful and subsequently treated with conventional pleurodesis using OK-432.ResultsThirty-nine patients were successfully treated with 50 % glucose, although 7 patients required further treatment with OK-432. The unsuccessful group had some pulmonary comorbidities (P < 0.001), and the pleural effusion volume after pleurodesis was less than that in the successful group (P < 0.001). Although the air leakage did not stop in unsuccessful patients, the amount of air leakage markedly decreased. A temporary elevation of the blood sugar level was observed in 20 patients, but no other side effects had appeared.ConclusionsPleurodesis with 50 % glucose is an easy, safe, and effective treatment modality. It is therefore considered to be a useful alternative method for pleurodesis.
Highlights
Pleurodesis is commonly performed for patients with pulmonary air leakage after lung resection and for those who should avoid surgery [1–5]
Only for patients with malignant pleural effusions, the use of purified talc was approved in December 2013 in Japan; OK-432 has been primarily used for postoperative air leakage and pneumothorax [6–9]
There have been several reports of the effectiveness of pleurodesis using a hypertonic glucose solution for secondary pneumothorax or chylothorax [15–17], this is the first report of the use of this procedure for all possible indications for pleurodesis, including postoperative air leakage after surgery and pneumothorax
Summary
Pleurodesis is commonly performed for patients with pulmonary air leakage after lung resection and for those who should avoid surgery [1–5]. Only for patients with malignant pleural effusions, the use of purified talc was approved in December 2013 in Japan; OK-432 has been primarily used for postoperative air leakage and pneumothorax [6–9]. Pleurodesis using OK-432 is currently the most commonly performed technique at our hospital as well. These methods aim for adhesion through an inflammatory reaction caused by pleural stimulation instilled by the preparations [10, 11]. The clinical characteristics of patients who underwent pleurodesis using 50 % glucose solution at our hospital and its effectiveness were evaluated
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