Treatment of pneumothorax with a modified central venous catheter and Thoracic Egg^®

Abstract

Many cases of outpatient drainage therapy for pneumothorax using Thoracic Egg^® (TE: Sumitomo Bakelite Company Limited, Tokyo, Japan) have been reported. Compared with a larger catheter, TE causes less pain and is easier to manage. In the case of a thick pleura, particularly in a young patient, however, a splitting procedure is necessary, which causes marked pain and, therefore, decreases the ADL. For the purpose of reducing the pain, we devised a new method using a modified central venous catheter (CV-TE). The CV-TE was applied to patients who had moderate to severe pneumothorax without pleural effusion. We studied a total of 69 patients with pneumothorax who received CV-TE treatment in Aizawa Hospital between September 2010 and August 2012. They were 58 males and 11 females, with an age ranging from 16 to 89 years (mean: 47). Thirty-three patients had spontaneous pneumothorax, 26 secondary pneumothorax (COPD), 6 traumatic pneumothorax, 2 iatrogenic pneumothorax, 1 postoperative air leakage, and 1 hemopneumothorax (this patient underwent unplanned treatment). In 56 cases (81 percent), use of the modified central venous catheter was successful for drainage; the remaining 13 cases required replacement with a larger-bore catheter because of insufficient drainage due to obstruction of the catheter, or for the purpose of additional pleurodesis. The CV-TE method proved to be useful for treating pneumothorax, reducing pain, and preventing a decrease in ADL.