Volume 6, Issue 2, March 2020, Page: 17-22
Pleuroplastic Inlay with Autologous Blood Versus Gel-foam Slurry as Innovative Remedies for Trapped Lung
Ahmed Mohammed Abumossalam, Chest Medicine Department, Faculty of Medicine, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
Asem Abdelhamid Hewidy, Chest Medicine Department, Faculty of Medicine, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
Received: Apr. 6, 2020;       Accepted: Apr. 22, 2020;       Published: Jun. 9, 2020
DOI: 10.11648/j.ijcts.20200602.11      View  47      Downloads  26
Abstract
Background: Residual pleural air following chronic empyema and intrapleural interventions implies a disgusting issue for restoration of pleural contour. Aim of work: This work was to assess the efficacy and safety of intrapleural instillation of patient autologous blood versus gel-foam slurry for obliteration and reduction of volume of residual pleural space following chronic empyema and pleural interventions as well as limitation of long term complications and as a substitute for surgical decortication. Patients and methods: This study was conducted on 28 patients with trapped lung due to chronic empyema after intercostal tube placement and were divided according to the instilled material into three groups: group A, included 9 patients who were instilled with autologous blood, group B; included 9 patients who were instilled with gel-foam slurry, group C, included 10 patients who were treated with oral Alphintern tablets three times daily for two month. Results: pulmonary functional evaluation showed that 50% reduction of total lung capacity (TLC) defect by > 75% in group A and > 65% in group B. Besides 50% reduction of computed chest tomography CT radiological volumetry was detected by > 65% in group A and by > 55% in group B while opacification of residual pleural space was found in more than 75% in group A and 85% of group B. Group C showed coalescence of pleural layers in 20% of cases. Conclusion: Intrapleural instillation of autologous blood and gel-foam slurry for obliteration of residual pleural space was associated with a reduction of (CT) chest volumetry and pulmonary function improvement.
Keywords
Trapped Lung, Gelfoam, Thoracoscopy, Autologous Blood
To cite this article
Ahmed Mohammed Abumossalam, Asem Abdelhamid Hewidy, Pleuroplastic Inlay with Autologous Blood Versus Gel-foam Slurry as Innovative Remedies for Trapped Lung, International Journal of Cardiovascular and Thoracic Surgery. Vol. 6, No. 2, 2020, pp. 17-22. doi: 10.11648/j.ijcts.20200602.11
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Doelken P. Clinical implications of unexpandable lung due to pleural disease. Am J Med Sci 2008; 335: 21.
[2]
Huggins JT, Doelken P, Sahn SA. The unexpandable lung. F1000 Med Rep 2010; 2: 77.
[3]
Moore PJ, Thomas PA. The trapped lung with chronic pleural space: a cause of recurring pleural effusion. Mil Med. 1967; 132: 998–1002.
[4]
Doelken P, Sahn SA. Trapped lung. Semin Respir Crit Care Med. 2001; 22: 631–6.
[5]
Feller-Kopman D, Walkey A, Berkowitz D, Ernst A. The relationship of pleural pressure to symptom development during therapeutic thoracentesis. Chest. 2006; 129: 1556–60.
[6]
Heidecker J, Huggins JT, Sahn SA, Doelken P. Pathophysiology following ultrasound-guided thoracentesis. Chest. 2006; 130: 1173–84.
[7]
Light RW, Rogers JT, Moyers JP, Lee YC, Rodriguez RM, Alford Jr WC, et al. Prevalence and clinical course of pleural effusion at 30 days after coronary artery and cardiac surgery. Am J Respir Crit Care Med. 2002; 166: 1567–71.
[8]
Lee YCG, Vaz MAC, Ely KA, McDonald EC, Thompson PJ, Nesbitt JC, et al. Symptomatic persistent post-coronary artery bypass graft pleural effusions requiring operative treatment: clinical and histologic features. Chest. 2001; 119: 795–801.
[9]
Huggins JT, Sahn SA, Heidecker J, Ravenel JG, Doelken P. Characteristics of trapped lung: pleural fluid analysis, manometry, and air-contrasted CT. Chest. 2007; 131: 206–13.
[10]
Goodman LS, Gilman A: Surface-acting drugs, in The Pharmacologic Basis of Therapeutics, ed 6. New York, MacMillan Publishing Co. 1980, p 955.
[11]
Ahmed M. Abumossalam, Asem A. Hewidy, Ahmed M. Abd El-khalek (2016): Iatrogenic pneumodesis: Gelfoam flux inoculation in focal benign cavitary lung lesion. Egyptian Journal of Chest Diseases and Tuberculosis (2016) 65, 711–716.
[12]
G. T. G. Knowlson, Gelfoam granuloma in the brain, J. Neuro. Neurosurg. Psychiatry 37 (1974) 971–973.
[13]
Marco F. Pereyra, Lucía Ferreiro, Luis Valdés_(2012): Unexpandable Lung. Arch Bronconeumol. 2013; 49 (2): 63–69.
[14]
Lan RS, Lo SK, Chuang ML, Yang CT, Tsao TC, Lee CH, et al. Elastance of the pleural space: a predictor for the outcome of pleurodesis in patients with malignant pleural effusion. Ann Intern Med. 1997; 126: 768–74.
[15]
Cases E, Seijo L, Disdier C, Lorenzo MJ, Cordovilla R, Sanchis F, et al. Use of indwelling pleural catheter in the outpatient management of recurrent malignant pleural effusion. Arch Bronconeumol. 2009; 45: 591–6.
[16]
Huggins JT, Sahn SA Drug induced pleural disease. Clin. Chest Med. 2004; 25: 141–153.
[17]
P. A. Lindstrom, Complications from the use of absorbable hemostatic sponges, AMA Arch. Surg. 73 (1956) 133–141.
[18]
J. H. Herndon, H. C. Grillo, E. J. Riseborough, et al, Compression of the brain and spinal cord following use of GELFOAM, Arch. Surg. 104 (1972) 107.
[19]
D. Nori, X. Li, T. J. Pugkhem, Intraoperative brachytherapy using gelfoam radioactive plaque implants for resected stage III non-small cell lung cancer with positive margin: a pilot study, Surg. Oncol. J. 60 (4) (1995) 257–261.
[20]
Sudish C. Murthy, M. Blair Marshal, Thorac. Surg. Clin. Lung Transpl. 25 (1) (2015) 87–88.
[21]
M. Lois, M. Noppen, Bronchopleural fistulas: an overview of the problem with special focus on endoscopic management, Chest 128 (2005) 3955–3965.
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