Therapeutic Pneumoperitoneum: Relevant or Obsolete in 2015?
Eitan Podgaetz1, Jonathan Berger1, Joe Small1
1Department of Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, Minnesota, United States.
The Thoracic and Cardiovascular Surgeon
|January 13, 2016
Summary
Therapeutic pneumoperitoneum (TP) is a safe and effective method for managing pleural space issues. This technique, involving insufflating air into the peritoneal cavity, shows promise for wider thoracic surgical application.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Critical Care Medicine
Background:
- Pleural space problems can be challenging to manage.
- Therapeutic pneumoperitoneum (TP) offers an alternative approach.
- This study details the technique and outcomes of TP.
Purpose of the Study:
- To describe the technique and patient experience with therapeutic pneumoperitoneum.
- To evaluate the safety and efficacy of TP in managing various pleural space problems.
- To assess the potential for wider application of TP in thoracic surgery.
Main Methods:
- Retrospective review of 32 patients undergoing TP from 2007-2015.
- TP involved placing a catheter and insufflating room air to a target pressure of 9-10 mm Hg.
- Data collected included indications, pulmonary function, air volume, and outcomes.
Main Results:
- TP was performed for diverse indications including post-bilobectomy, empyema, air leak, and chylothorax.
- Median air volume used was 3.5 L.
- Patients experienced a median chest tube removal time of 7.8 days and discharge time of 10.2 days, with no major complications like respiratory or renal failure.
Conclusions:
- Therapeutic pneumoperitoneum is a simple, safe, and effective technique.
- Careful patient selection and meticulous technique are crucial for successful TP.
- TP is an underutilized tool that warrants broader use in thoracic surgery.
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