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Medical Thoracoscopy-assisted Thoracographic Fibrin Glue Sealing Method for Intractable Pneumothorax: A Case-based
So Takata1,2,3, Naoto Kitahara4, Susumu Takahashi5
1Department of Pulmonary and Critical Care Medicine, Osaka Habikino Medical Center, Japan.
Internal Medicine (Tokyo, Japan)
|August 27, 2025
Summary
A novel hybrid technique, medical thoracoscopy-assisted thoracographic fibrin glue sealing (MTS-TGF), successfully treated refractory pneumothorax in interstitial lung disease. This minimally invasive approach offers precise, safe air leak management without surgery.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Interventional Pulmonology
Background:
- Refractory pneumothorax poses a significant challenge, especially in patients with underlying interstitial lung disease.
- Conventional treatments may be insufficient for persistent air leaks in complex cases.
- Minimally invasive options are sought to improve patient outcomes and reduce treatment burden.
Purpose of the Study:
- To report a case of refractory pneumothorax in interstitial lung disease successfully treated with a novel technique.
- To evaluate the efficacy and safety of medical thoracoscopy-assisted thoracographic fibrin glue sealing (MTS-TGF).
- To highlight MTS-TGF as a potential minimally invasive alternative to surgery for persistent air leaks.
Main Methods:
- A patient with refractory pneumothorax and interstitial lung disease underwent MTS-TGF.
- This hybrid technique combined direct visualization via medical thoracoscopy with fluoroscopic guidance for fibrin glue delivery.
- The procedure aimed for accurate localization and sealing of air leaks.
Main Results:
- MTS-TGF enabled precise identification and targeted delivery of fibrin glue.
- The procedure resulted in substantial reduction of the air leak.
- Complete resolution of pneumothorax was achieved without the need for surgical intervention.
Conclusions:
- MTS-TGF is a promising, minimally invasive technique for managing refractory pneumothorax.
- The hybrid approach enhances precision and safety compared to conventional fibrin glue sealing.
- MTS-TGF represents a viable option for persistent air leaks, particularly in high-risk or complex patients where surgery is contraindicated.
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