The incidence of apical pleural adhesion band between lung apex and thoracic wall detected by CT in spontaneous pneumothorax-Proposal of a new indication for VATS

Abstract

The apical pleural adhesion band may be life-threatening in cases of pneumothorax. We analyzed 154 consecutive pneumothorax cases at the initial onset using computed tomography (CT) to assess whether these bands are detectable. CT depicted the band in 31 out of 154 cases, while 4 cases were overlooked, confirmed by subsequent VATS. The apical pleural adhesion band was finally revealed in a total of 35 cases, meaning that 31 out of 35 cases, 88.6% sensitivity, were detected by CT. This favorable sensitivity supports the routine use of CT for pneumothorax cases, suggesting that cases showing the band should be indicated for VATS regardless of whether or not it is the first onset.