A research team at National Taiwan University Hospital (NTUH) reported that it has found a way to effectively cut the recurrence or need for surgery for a potentially life-threatening condition known as primary spontaneous pneumothorax.
The condition occurs when gas accumulates between a person’s lung and chest wall, compressing the lung, which may then collapse.
Yang Pan-chyr (楊泮池), dean of NTU College of Medicine, said on Thursday that the research team worked with Far Eastern Memorial Hospital on large-scale clinical trials, the results of which were published in the medical journal The Lancet.
Chen Jin-shing (陳晉興), a surgeon at the university hospital and one of the research team members, said that more than 2,000 people in the country each year require catheter drainage or surgery due to serious spontaneous pneumothorax.
The condition usually affects tall, slender men aged 15 to 40, causing sudden chest pains, breathlessness and coughing. A serious case can result in death.
Chen said that simple aspiration and drainage are the standard initial treatment, but treatment failure or recurrence is as high as 50 percent.
He said that in an effort to cut the recurrence rate, the team randomly assigned 214 patients between Dec. 31, 2006, and June 30 last year to two groups.
After simple aspiration and drainage via catheter, patients were randomly assigned to either undergo a procedure known as minocycline pleurodesis — in which an antibiotic is used to close the pleural cavity by inducing adhesion of the visceral and parietal pleural layers — or to be in the control group, with no further treatment.
At one year, pneumothoraxes had recurred in 31 of the 106 patients in the minocycline group, compared with 53 out of 108 in the control group.
The recurrence rate for patients in the minocycline group was 40 percent less than in the control group, while the surgery rate was down by 34 percent, Chen said.
The team concluded that simple aspiration and drainage, followed by minocycline pleurodesis, is a safe and more effective treatment for primary spontaneous pneumothorax.
The findings were also published on MDLink, a secure medical Web portal.