[Transbronchoscopic balloon detection and selective bronchial occlusion for intractable pneumothorax]

Area of Science:

• Pulmonology
• Interventional Pulmonology
• Thoracic Surgery

Background:

• Intractable pneumothorax often requires prolonged chest tube drainage, with persistent air leaks posing a significant clinical challenge.
• Failure of conventional treatments necessitates exploring minimally invasive therapeutic options.

Purpose of the Study:

• To evaluate the efficacy, safety, and complication profile of transbronchoscopic balloon detection (TBD) and selective bronchus occlusion (SBO) for managing intractable pneumothorax.

Main Methods:

• A study involving 40 patients with pneumothorax unresponsive to chest tube drainage (>7 days) was conducted.
• TBD identified bronchi leading to persistent air leaks, followed by SBO using autologous blood and thrombin injection.
• Control group underwent bronchoscopy without TBD/SBO; outcomes including oxygenation, CT scans, and blood counts were monitored.

Main Results:

• TBD successfully located target bronchi in 34 of 40 cases, with SBO achieving initial air leak cessation in 30 patients.
• Overall, SBO led to successful treatment in 28 of 34 cases, with 2 requiring surgery.
• No significant differences in oxygenation were observed between groups; fever was mild and transient in 5 patients, with no obstructive atelectasis on CT scans.

Conclusions:

• Transbronchoscopic balloon detection and selective bronchus occlusion represent safe and effective therapeutic options for intractable pneumothorax.
• These minimally invasive techniques offer a viable alternative to surgery in selected patients with persistent air leaks.