https://doi.org/10.4081/monaldi.2024.2994

Thoracoscopic blood patch instillation for persistent air leak in pneumothorax: a case series and systematic review

Early Access
Submitted: March 17, 2024
Accepted: March 22, 2024
Published: April 5, 2024
Thoracoscopy, persistent air leak, autologous blood patch pleurodesis, pneumothorax
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Authors

Yash Kedia
https://orcid.org/0000-0002-0453-0039
Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, New Delhi, India.
Manu Madan
https://orcid.org/0000-0001-9245-4568
Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, Delhi, India.
Rajnish Kaushik
https://orcid.org/0009-0008-3985-4659
Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, Delhi, India.
Rohit Kumar
https://orcid.org/0000-0001-6398-7840
Department of Pulmonary Medicine, VMMC and Safdarjung Hospital, New Delhi, India.
AJ Mahendran
https://orcid.org/0000-0003-4907-1312
Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, Delhi, India.
Pranav Ish
Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, Delhi, India.
Neeraj Gupta
https://orcid.org/0000-0003-2776-0125
Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, Delhi, India.
Tanmaya Talukdar
Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, Delhi, India.
Nitesh Gupta
niteshgupta2107@gmail.com
https://orcid.org/0000-0002-5842-5584
Department of Pulmonary and Critical Care Medicine, VMMC and Safdarjung Hospital, Delhi, India.

Persistent air leaks in patients with pneumothorax can lead to significant morbidity. If a patient with persistent air leak is medically unfit for thoracic surgery, medical pleurodesis via chest tube or thoracoscopy is either an option. Thoracoscopy offers the advantage of visualizing the site of the air leak and enabling direct instillation of the pleurodesis agent or glue at that location. Autologous blood patch instillation via chest tube has been reported to be a cheap and very effective technique for the management of persistent air leaks. However, thoracoscopic blood patch instillation has not been reported in the literature. We report two cases of secondary spontaneous pneumothorax in which patients had persistent air leaks for more than seven days and were subjected to thoracoscopy to locate the site of the leak. In the same sitting, 50 mL of autologous blood patch was instilled directly at the leak site. Post-procedure, the air leak subsided in both patients, and the chest tube was removed with complete lung expansion. We also conducted a systematic review of the use of medical thoracoscopic interventions for treating persistent air leaks.

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How to Cite

Kedia, Yash, Manu Madan, Rajnish Kaushik, Rohit Kumar, AJ Mahendran, Pranav Ish, Neeraj Gupta, Tanmaya Talukdar, and Nitesh Gupta. 2024. “Thoracoscopic Blood Patch Instillation for Persistent Air Leak in Pneumothorax: A Case Series and Systematic Review”. Monaldi Archives for Chest Disease, April. https://doi.org/10.4081/monaldi.2024.2994.
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