Partial pleural covering can reduce recurrent pneumothoraces

At the 5th BHD Symposium in 2013 Professor Kurihara presented data suggesting that partial lung covering (PLC) was an effective treatment that could reduce the risk of recurrent pneumothorax in BHD patients (5th BHD Symposium Abstracts (abstract 14)). This method is proposed as an alternative to pleurodesis which can result in reduced pulmonary function and make subsequent surgeries difficult. A new report from Okada et al., (2105) confirms the efficacy of PLC in three patients, genetically confirmed to have BHD, who have suffered no recurrent pneumothoraces since surgery (30-32 months).

PLC involves the use of a bioabsorbable membrane – either polyglycolic acid felt or regenerative oxidized cellulose mesh – and fibrin glue to inhibit air leakages and reinforce the plural walls. Okada et al. combined this technique with VATS-assisted wedge resection to remove ruptured cysts and thin-wall externally bulging cysts. The bioabsorbable membranes were then used to cover all excision sites and remaining unruptured cysts. Although more long term results are required this suggests that PLC could be a valid treatment in BHD and other cystic lung diseases.

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