Treatment Of Spontaneous Pneumothorax By Mechanical Pleurodesis

Objective: To identify the necessity of mechanical pleural fixation in the treatment of spontaneous pneumothorax and to find a way to improve the curative effect and reduce postoperative complications.Methods: A total of 171 patients with spontaneous pneumothorax who were diagnosed as spontaneous pneumothorax from January 2012 to March 2016 in our hospital and treated by thoracoscopic surgery were selected.In group A,65 cases(52 males and 13 females)were treated with VATS pneumonectomy and pleural fixation,with an average age of 34.77(17~ 73).29 cases of closed thoracic drainage in local hospital before operation.There were 92 cases of B group without pleura fixation(including 76 males and 16 females),with an average age of 34.66(16~72).39 patients underwent thoracic closed drainage before operation.Before operation,39 cases were treated with thoracic closed drainage in local hospital.Two groups of patients postoperative pleural effusion volume,operation time,postoperative chest tube indwelling time,intraoperative blood loss,postoperative 24 h chest drainage,recurrence rate,postoperative complications(pleural effusion,leakage,pulmonary infection and postoperative hospitalization days)comparison.Results: The total amount of pleural effusion in group A was higher than that in group B,The total volume of pleural drainage and pleural effusion in group A was higher than that in group A 24 hours after operation(P > 0.05),and the days of hospitalization in group A were higher than that in group A.At 24 hours after operation,the volume of thoracic drainage and drainage were higher than that in group B(P > 0.05).Conclusion: Mechanical pleural fixation can not reduce the recurrence rate of pneumothorax.For patients with closed drainage of thoracic cavity before operation,mechanical pleural fixation during operation can effectively shorten the postoperative hospital stay,so it is recommended that mechanical pleural fixation should be added,and those who do not have closed pleural drainage before operation,and those who do not have mechanical pleural drainage before operation,should be treated with mechanical pleural fixation.Mechanical pleural fixation can reduce the operation time,but it will increase the drainage of pleural effusion 24 hours after operation,the total amount of pleural effusion drainage and the postoperative hospital stay.Therefore,mechanical pleural fixation is not recommended.