O-139
THORACOGRAPHIC FIBRIN GLUE SEALING: A NOVEL INTERVENTIONAL TREATMENT FOR PNEUMOTHORAX WITH INTRACTABLE PERSISTENT AIR LEAKAGE

Objectives: We developed an innovative interventional treatment which could selectively stop air leakage for pneumothorax with intractable persistent air leakage or inoperable condition. This was named the thoracographic fibrin glue sealing method (TGF).

Methods: TGF was applied to 190 cases with intractable persistent air leak pneumothorax. The patients were between 18 and 92 years old. The patients were 99 cases of chronic obstructive pulmonary disease (COPD), 21 cases of interstitial pneumonia, 29 cases with remarkable adhesion, 40 cases of postoperative intractable air leakage, and one case of cerebral infarction at brain stem. TGF is performed in X-ray room. First, the air leak point is identified by thoracography (pleurography) with a contrast medium. Secondly the double lumen catheter is inserted through a chest tube and guided to the air leak point. Fibrin Glue A and B, each diluted with contrast media, are dropped in alternation slowly just at the air leak point to confirm clearly that the air leakage has perfectly stopped.

Results: One hundred and thirty-one of 190 cases were sealed soon after dropping the fibrin glue. Thirty eight cases were sealed in less than 24 hours and eight cases in less than 72 hours. Thirteen cases were not sealed, although air leakage was decreasing. It is known that pleurodesis makes respiratory function often worse and that it is often ineffective on intractable pneumothorax. This is because pleurodesis is usually performed at patients' bedside. It is impossible to confirm if the chemicals have reached the air leak point. TGF is an interventional treatment which is aiming at an air leak.

Conclusion: TGF is an innovative method which can effectively seal the air leak point in patients with prolonged intractable pneumothorax.

Disclosure: No significant relationships.