Intrapleural minocycline pleurodesis for the treatment of primary spontaneous
pneumothorax.
Author(s): Chen JS(1), Chan WK, Yang PC.
Affiliation(s): Author information:
(1)aDepartment of Surgery, National Taiwan University Hospital and National
Taiwan University College of Medicine bDepartment of Medical Research, National
Taiwan University Hospital cDepartment of Internal Medicine, National Taiwan
University Hospital and College of Medicine, National Taiwan University, Taipei,
Taiwan.
Publication date & source: 2014, Curr Opin Pulm Med. , 20(4):371-6
PURPOSE OF REVIEW: The role of chemical pleurodesis in the treatment of primary
spontaneous pneumothorax remains unclear. According to current practice
guidelines, chemical pleurodesis is reserved for patients who are unable or
unwilling to have surgery. Some recent studies showed that intrapleural
minocycline pleurodesis could decrease the rate of pneumothorax recurrence, when
used either as the initial treatment for simple pneumothorax after successful
aspiration and drainage or as an adjuvant treatment for complicated or recurrent
pneumothorax following thoracoscopic surgery. The purpose of this review is to
discuss the current available evidence on intrapleural minocycline pleurodesis
for the treatment of primary spontaneous pneumothorax.
RECENT FINDINGS: In a recently published prospective, randomized controlled
trial, additional minocycline pleurodesis following simple aspiration and
drainage was a well tolerated and more effective initial treatment for a first
episode of primary spontaneous pneumothorax than simple aspiration and drainage
alone. Other prospective, randomized controlled trials showed that additional
minocycline pleurodesis after thoracoscopic treatment was a well tolerated and
convenient procedure which can reduce the rate of ipsilateral recurrence of
primary spontaneous pneumothorax.
SUMMARY: Intrapleural minocycline pleurodesis can be considered an adjunct to
standard treatment of primary spontaneous pneumothorax, after either simple
aspiration and drainage or after thoracoscopic surgery.
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