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KMID : 0364019960290010059
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Korean Journal of Thoracic and Cardiovascular Surgery
1996 Volume.29 No. 1 p.59 ~ p.62
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Effects of Intraoperative Doxycycline Pleurodesis with Concomitant Video-assisted Thoracoscopic Bullectomy
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Abstract
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Chemical pleurodesis with doxycycline has been used during video-assisted thoracoscopic surgery(VATS) as an auxiliary method to enhance therapeutic goal in patients with pneumothorax. However, the therapeutic effect of doxycycline
pleurodesis(DP)
has
not been clearly defined yet. To evaluate the effect of DP, we compared two groups of patients who were given VATS bullectomy from October 1993 to June 1995. Group I composed of 21 patients who received DP and group II composed of 20 patients who
did
not received DP. Doxycycline 500mg with saline 200ml were instilled into the pleural cavity upon a completion of bullectomy, and retained there for 0.5-1 hour and then drained out. The age of group I was 30.9±20.0 and that of group II was
24.3±9.49
years. Male to female ratio was 20:1 in group I and 20:0 in group II. The postoperative indwelling time of chest tube was 5.86±4.69 days in group I and 3.80±2.28 days in group II. Seven patients had more than 100ml/day of chest tube drainage on
the
postoperative third day in group I compared to one patient in group II. Five patients had postoperative indwelling time of chest tube greater than 7 days in group I compared to two in group II. The number of patients who had postoperative fever
were 3
in both group, analgesic requirements were 2.19±2.77 amples in group I and 2.30±1.95 amples in group II. Follow-up was done from 2 months to 16 months after surgery. During the follow up periods, four patients had recurrence 2 (9.5%) in group I
and 2
(10%) in group II. We conclude that concomitant doxycycline pleurodesis with video-assisted thoracoscopic bullectomy in patients with pneumothorax is not necessary.
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