The spontaneous pneumothorax is the sudden collapse of the lung usually by air leakage from the ruptured sub-pleural bleb and has high recurrence rate.
For prevention against recurrence, many drugs such as tetracycline, talcum powder, quinacrine, etc, have been used but the effects are not satisfactory. We reduced the recurrence rate successfully by the fibrin glue instillation through the chest tube.
From the January 1989 to September 1990, we have managed 65 patients of spontaneous pneumothorax with closed thoracostomy and fibrin glue(fibrinogen lgrr, /50m1 with aprotinin 3,OOOklu/ml, thrombin 5,000lu/ml in 3% cacti 10ml) instillation-through the chest tube. And we compared the results with those of 106 patients of spontaneous pneumothorax who were managed only by the closed thoracostomy from January 1985 to Dec-ember 1988.
Only the patients who visited our hospital with recurrence were considered as the recurred cases but the others were considered as not recurred. And the removal of chest tub-es usually done 3 days after cessation of air leakage or 2 days after fibrin glue instillation.
Statistical analysis was done by X2-tast.
The results were as .followings :
1. The recurrence rate of fibrin glue instillation group was lower than that of non-instillation group(lst attack : 15.1% versus 27.6% p<0.05, the 2nd attack : 33.3% versus 73.7% p0.01, the total 18.5% versus 35.8% p<0.01).
2. The mean duration of chest tube drainage in the fibrin glue instillation group was shorter than non-instillation group(4.241.36 days versus 4.481.73 days p<0.05).
3. The mean duration of hospitalization was shorter in the instillation group (8.123.5 days versus 10.83.8 days p<0.05)
The complications were transient mild fever, chest pain, pleural effusion in 46 cases of 65 patients, but those didn´t make any problem.
We concluded that the fibrin glue is effective in the reduction of recurrence rate, obliteration of air leakage and duration of hospitalization.
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