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Osteopathic Manipulative Treatment as a Useful Adjunctive Tool for Pneumonia
Published on: May 6, 2014
[Therapeutic strategy for spontaneous pneumothorax].
Shinji Hirai1, Y Hamanaka, N Mitsui
1Department of Thoracic and Cardiovascular Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|March 14, 2007
Summary
Video-assisted thoracoscopic surgery (VATS) and limited thoracotomy (LT) are recommended for spontaneous pneumothorax with bulla/bleb, showing lower recurrence than observation. VATS with PGA sheets and fibrin glue, and LT with suturing, further reduce recurrence.
Area of Science:
- Thoracic Surgery
- Pulmonology
- Medical Imaging
Background:
- Spontaneous pneumothorax is a condition requiring effective treatment to minimize recurrence.
- Chest computed tomography (CT) aids in identifying bulla and/or bleb, key factors in recurrence.
- Surgical interventions like VATS and LT are options for managing spontaneous pneumothorax.
Purpose of the Study:
- To evaluate and compare the recurrence rates of different treatment modalities for spontaneous pneumothorax.
- To assess the impact of bulla and/or bleb presence on pneumothorax recurrence.
- To determine the efficacy of VATS and LT in preventing pneumothorax recurrence.
Main Methods:
- Retrospective analysis of 168 spontaneous pneumothorax cases treated between April 1998 and October 2004.
- Chest CT imaging used to identify bulla and/or bleb.
- Comparison of treatment groups: observation (chest tube, bed rest), VATS, and LT.
Main Results:
- Recurrence rates were 42% for observation, 13% for VATS, and 0% for LT.
- Patients with bulla and/or bleb had a higher recurrence rate (48%) compared to those without (20%).
- VATS with polyglycolic acid (PGA) sheets and fibrin glue, and LT with primary suturing, showed promise in preventing recurrence.
Conclusions:
- VATS or LT are recommended for spontaneous pneumothorax, especially when bulla and/or bleb are present on CT.
- Surgical techniques like auto-sutured lines with PGA sheets and fibrin glue in VATS, and primary suturing in LT, are effective in reducing recurrence.
- These findings support tailored surgical approaches based on intraoperative findings of bulla and/or bleb.
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