P3.04-035 Pleurodesis with a 50% Glucose Solution for Post-Operative Pneumothorax, after Curative Lung Cancer Resection: Topic: Miscellaneous II

Abstract

Pleurodesis plays an important role in the management of pneumothorax, especially among patients who underwent curative lung cancer resection. Previous papers reported the efficacy of pleurodesis with OK-432, talc, or other cytotoxic agents, but these agents sometimes trigger lethal complications. Recently, several institutions reported 50% glucose solution as pleurodesis for pneumothorax. And we adopt it for post-operative pneumothorax patients. We report the feasibility of pleurodesis with 50% glucose solution for post-operative pneumothorax, after curative lung cancer resection. From October 2014 to March 2016, 13 cases of post-operative pneumothorax after curative lung cancer resection were treated in our hospital. They were treated with pleurodesis with a 50% glucose solution. 200 mL of a 50% glucose solution with 10 mL of 1% lidocaine was instilled into the pleural cavity. Patients regularly change their positions for 2 hours, due to immerse whole visceral pleura. Pleurodesis was repeated until the air leakage stopped. The subjects were 10 men and 3 women, with a mean age of 71 years. 9 patients were past or current smokers. All cases underwent video-assisted-thoracic-surgery (VATS) lobectomy, and Right upper/middle/lower/Left upper/lower lobe resections were 5/2/3/2/1 cases each. Air leakage stopped after pleurodesis in all cases, and 2 cases required pleurodesis twice. No patient required re-operation, and was suffered from high fever, chest pain, or other complications. Drain tube was removed in 2.9 days after pleurodesis on average, and there was no post-treatment recurrence. These results demonstrated feasibility of pleurodesis with a 50% glucose solution for post-operative pneumothorax, after curative lung cancer resection. This procedure can be the first choice for post-operative pneumothorax treatment.