An Audit of medical thoracoscopy and talc poudrage for pneumothorax prevention in advanced COPD
| Autor: | Pyng Lee, Alan Wei Keong Ng, Wee See Yap, Wee Yang Pek |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Time Factors medicine.medical_treatment Myocardial Ischemia Critical Care and Intensive Care Medicine Pulmonary Disease Chronic Obstructive Recurrence Thoracoscopy Medicine Humans Local anesthesia Pleurodesis Aged COPD Medical Audit medicine.diagnostic_test business.industry Mortality rate Pneumothorax Length of Stay medicine.disease respiratory tract diseases Surgery Treatment Outcome Talc Video-assisted thoracoscopic surgery Drainage Female medicine.symptom Safety Cardiology and Cardiovascular Medicine business Chest radiograph Subcutaneous emphysema |
| Zdroj: | Chest. 125(4) |
| ISSN: | 0012-3692 |
| Popis: | Objectives: To prospectively study all patients with COPD and spontaneous pneumothorax (SP) who underwent thoracoscopic talc poudrage (TP) under local anesthesia to determine its efficacy and safety in recurrence prevention. Methods: Data on clinical measurements, complications, duration of chest tube drainage, length of hospital stay, and outcome were collected. Results: Forty-one patients (38 men and 3 women) with a mean ( SD) age of 70.7 7.2 years were treated. All patients had COPD, with a mean FEV1 of 41 14% predicted. The majority of SPs measured 20 to 50% in size, and 34% were recurrent. Three grams of talc were insufflated into the pleural cavity without complications. Thirteen patients (32%) complained of pain, 5 (12%) developed fever, 27 (66%) had subcutaneous emphysema, and 7 (17%) had prolonged air leaks. Postoperative chest tube drainage and hospital stay were 4 and 5 days, respectively. Success was 95% after a median follow-up of 35 months. Four patients with FEV1 of < 40% predicted died within 30 days of the procedure, yielding a mortality rate of 10%. FEV1 (in liters), FEV1 (in % predicted), and ischemic heart disease were risk factors that influenced early mortality. Conclusion: Thoracoscopic TP is effective for pneumothorax prevention and can be performed with acceptable mortality in patients with advanced COPD. (CHEST 2004; 125:1315–1320) |
| Databáze: | OpenAIRE |
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