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RISS 인기검색어
- 검색키워드
- 저자 : 김보택 (검색결과 1 건)
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김보택 Korea University 2017 국내석사
Background & objectives: There has been no optimal chemical agent for pleurodesis in managing patient with pneumothorax during the surgical intervention by video-assisted thorascopic surgery (VATS). In many studies, however, Iodopovidone and minocycline have been accepted as safe and effective chemical agents in pleurodesis. This is the first study to discuss the relationship between these two chemical agents, finding and updating the comparison of these two chemical agents in the aspects of efficacy and safety Design: Retrospective comparative study Setting: Cardiovascular and thoracic surgical division of university-affiliated tertiary medical center Methods: Between February 2009 and October 2013, 332 patients at Korea Universtiy Guro Hospital with primary spontaneous pneumothorax were managed by VATS. The method included resection of blebs and chemical pleurodesis by either iodopovidone or minocycline. For parallel comparison, two groups were divided accordingly: group of patients with iodopovidone pleurodesis and the other group of patients with minocycline pleurodesis. Amount of chest drainage, postoperative hospital stay, visual analogue scale, blood test and complication rates were compared between the two groups. Results: Amounts of chest tube drainages per postoperative days show significant difference in minocycline pleurodesis for day 2, day 3, day 4,day 5, and day 7 (167.480 cc, 143.793 cc, 118.293 cc, 114.348 cc and 36.667 cc in minocycline, and 531.195 cc, 328.787 cc, 221.709 cc, 183.547 cc, and 154.288 cc in iodopovidone; p <0.01). Duration of chest tube insertion and period of hospitalization after surgery are significant different. (4.276 ± 1.5185 days and 6.076 ± 2.242 days in minocycline group, and 7.298 ± 2.298 days and 9.688 ± 3.112 days in iodopovidone group; p < 0.01). There was no statistical difference in Visual Analogue Scale from day 0 to day 9 between the two groups (2.95, 2.573, 2.235, 2.222, 2.132, 2.209, 2.111, 1.867, 2.5, and 2 in minocycline group, and 2.76, 2.649, 2.547, 2.426, 2.277, 2.222, 2.259, 2.119, 2.205, and 2.206 in iodopovidone group). The most common complications were fever, air leak, and tube reinsertion (17.323 %, 8.661 %, and 7.874 in minocycline group, and 12.683, 13.171, and 6.830 in iodopovidone group; p=0.243, p=0.210, p=0.721), but there was no significant difference. Interpretation & Conclusions: Although rates of some complication including fever and tube reinsertion are shown to be higher in minocycline group, there is no finding of statistical difference. Moreover, there is no difference in Visual Analogue Scale between the two groups. However, both duration of chest tube insertions and period of hospitalization after the surgery are significantly shorter in minocycline pleurodesis than iodopovidone pleurodesis, assuring patients’ convenience and quality of postoperative care. In summary, this study provides an evidence that minocycline pleurodesis after VATS is an effective procedure to manage patients with pneumothorax.
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