There are also several reports of pleurodesis for the treatment of spontaneous pneumothorax. In particular, the injection of tetracycline into the pleural cavity is considered effective, with few side effects; however, this method results in adherence of one entire lobe of the lung to the chest cavity. Although it is effective in stopping air leakage, there have been no reports concerning problems in pulmonary function which may occur in later life. In other words, when a patient who had been afflicted with pleuritis in youth is afflicted later in life with a disease such as pneumonia or lung cancer that entails dyspnea or requires surgery, we routinely find an exacerbation of symptoms or difficulties in carrying out surgery due to impairment in pulmonary function.
Consequently, we have performed total pleurodesis in only a very few cases where extensive pleural adhesions were already present or high risk prevented thoracoscopy or surgery. The spraying of fibrinogen and thrombin solutions onto the surface of the bleb causes only local pleural adhesion, and no impairment in pulmonary function occurs. We believe that this is entirely different from the so-called pleurodesis performed for spontaneous pneumothorax. In conclusion, the method that we have developed for the treatment of spontaneous pneumothorax using a modified FB overcomes many of the problems associated with the use of a rigid thoracoscope, provides the internist with more therapeutic options, and can provide better therapeutic results than previously reported methods.