Primary Spontaneous Pneumothorax Clinical Trial
Official title:
Assessment of Tetracycline Pleurodesis in Prevention of Primary Spontaneous Pneumothorax Recurrence in Patients With Normal CT-scan
Primary spontaneous pneumothorax (PSP) defines as presence of air in chest cavity occurs most
commonly in young, tall, and smoker men without underlying lung disease.
Trends for PSP treatment tend toward more invasive procedures. Thoracotomy with pleurectomy
and bullectomy is definitive treatment of PSP which significantly reduces recurrence
probability. This procedure has been reported to cause high rate of morbidity and mortality.
Thus video-assisted thoracoscopic surgery (VATS) has become the preferred method for
treatment of PSP with recurrence rate of 5-10%. For persistent or recurrent cases, mechanical
or chemical pleurodesis have been suggested.
Based on guidelines patients with large size of lesions in CT or with unstable condition
should undergo surgical procedure for recurrence prevention but Patients with small lesion
size and stable condition can be only observed. Conservative management of PSP is safe and
effective, but as mentioned this method has high recurrence rate. On the other hand fear of
recurrence can negatively affect patients' quality of life, so that some patients prefer
surgical intervention to observation management. Also some studies recommend invasive
treatments because of cost effectiveness of this methods.
As mentioned above, chemical pleurodesis is a usual method for treatment in patients with
persistent or recurrent spontaneous pneumothorax. This method has been done using variety of
chemical agents including tetracycline, minocycline, blood, and talc to irritate pleura.
According to different studies tetracycline has the highest efficacy between irritant agents.
In current study, the investigators have aimed to assess tetracycline chemical pleurodesis
through tube thoracostomy in prevention of spontaneous pneumothorax in symptom free patients
with normal CT-scan following first episode of PSP.
n/a
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