Pneumothorax pleurodesis: what are the advantages and disadvantages?

Written by Han Shun Li

Pulmonology

Updated on September 03, 2024

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Pleurodesis for pneumothorax involves injecting a sclerosant into the pleural cavity to induce a sterile inflammation, causing adhesion of the parietal and visceral pleurae, thereby eliminating the pleural space. This can be used to treat pneumothorax. The benefits include a high success rate, simple operation, and low recurrence rate. The downside is that there can be adverse reactions, the most common being chest pain and fever; severe cases may cause acute respiratory distress syndrome. Therefore, extra care is needed during the pleurodesis procedure.

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Written by Zhang Zhi Gong

Cardiothoracic Surgery

1min 15sec

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The difference between tension pneumothorax and open pneumothorax.

The main difference between a tension pneumothorax and an open pneumothorax lies in the relative pressures of the pleural cavity compared to the atmospheric pressure. An open pneumothorax occurs when the pleural cavity is in an open state due to some reason. During inhalation, gas can enter the pleural cavity, and during exhalation, the gas can be expelled through this opening or another opening, resulting in pleural cavity pressure that is roughly equal to the atmospheric pressure. In a tension pneumothorax, due to some reason, a one-way valve is formed. The gas enters the pleural cavity easily but encounters resistance during expulsion, causing the pressure in the patient's pleural cavity to increase progressively. The gas can only enter the pleural cavity and cannot be effectively expelled. Therefore, the main difference between a tension pneumothorax and an open pneumothorax is the level of pleural cavity pressure compared to atmospheric pressure; in a tension pneumothorax, the pressure in the pleural cavity is significantly higher than the atmospheric pressure, while in an open pneumothorax, the pressures are roughly equal.

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Written by Zhang Zhi Gong

Cardiothoracic Surgery

1min 12sec

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How to treat recurrent pneumothorax for the second time?

Patients with recurrent pneumothorax, we recommend proactive minimally invasive surgical intervention. For patients experiencing their first recurrence of pneumothorax, the likelihood of a second recurrence is about 20-30%. For those who have had two episodes of pneumothorax, it indicates the presence of a small rupture on the lung, or an area that has not healed well, or is particularly weak. Thus, for patients who have had two episodes or a second occurrence of pneumothorax, if they do not receive active treatment, the probability of a third recurrence rises to about 70-80%. Whether using minimally invasive surgery or the conservative method of simple tube insertion, both are certainly burdensome for the patient. However, for patients with a second occurrence of pneumothorax, undergoing a small minimally invasive surgery, which involves a small incision of one to two centimeters under the armpit to treat the pneumothorax, dramatically reduces the likelihood of subsequent occurrences from the previous 70-80% to below 10%. Therefore, the best treatment for a second pneumothorax episode is through minimally invasive surgical intervention.

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Written by Zhang Zhi Gong

Cardiothoracic Surgery

1min 11sec

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Can pneumothorax be inherited?

In fact, medicine has found that most diseases, other than traumatic ones caused by injuries or car accidents, are related to genes or heredity. For instance, diseases like diabetes and hypertension clearly have a familial hereditary history. Pneumothorax is no exception, as it also tends to cluster in certain families, or has a higher tendency than in normal families. Therefore, pneumothorax does possess a certain hereditary nature, particularly in families prone to connective tissue disorders such as Marfan Syndrome. Additionally, pneumothorax often occurs in families with mutations in the human leukocyte antigen, and in those with conditions such as homocystinuria or antitrypsin deficiency, where pneumothorax is more prevalent. Of course, there are also conditions like Marfan Syndrome and Birt-Hogg-Dube (BHD) Syndrome in these families, which also tend to develop renal cysts, renal tumors, and skin fibrofolliculomas. Thus, the more frequent occurrence of pneumothorax in these families demonstrates that pneumothorax is genetically related and has a certain degree of heredity.

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Written by Han Shun Li

Pulmonology

55sec

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Is pneumothorax the same as emphysema?

Pneumothorax and emphysema can both manifest symptoms such as chest tightness, difficulty breathing, and coughing. However, is pneumothorax the same as emphysema? Pneumothorax and emphysema are two different diseases. Simply put, pneumothorax is a pleural disease caused by a rupture of the pleura, while emphysema is a disease of the airways. When a lung is imaged for pneumothorax, the film shows lung compression. It is possible to see the external boundary of the compressed lung where pneumothorax is present, with no lung markings. In the case of emphysema, imaging shows that the thoracic cage is expanded, with widened intercostal spaces, and increased translucency in both lung lobes. Therefore, the differences between pneumothorax and emphysema are significant, and they are not the same disease.

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Written by Yuan Qing

Pulmonology

37sec

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The fastest method for spontaneous pneumothorax recovery.

Pneumothorax is mainly caused by various reasons that allow air inside the lungs to enter the pleural cavity, resulting in the accumulation of gas and the compression of the lung, reducing its volume. Clinically, for patients with lung compression not exceeding 30%, a conservative approach is typically chosen, which involves allowing the patients to heal naturally. For these patients who wish to accelerate their recovery, it is generally recommended to inhale high concentrations of oxygen, which can aid in the healing of the lungs. Additionally, it is important to increase nutrition and protein intake to enhance lung repair and recovery.