Effects of OK-432 Chemical Pleurodesis for Primary Spontaneous Pneumothorax: A Case-Control Study

Background: Ipsilateral recurrence rate of primary spontaneous pneumothorax after video-assisted thoracoscopic surgery is higher than that after open surgery. This study aimed to evaluate the safety and efficacy of additional OK-432 pleurodesis after pleural abrasion for primary spontaneous pneumothorax patients. Methods This is a case-control study enrolling a total of 254 patients with primary spontaneous pneumothorax. 130 patients underwent blebs resection and pleural abrasion in the control group. 124 patients were enrolled in the OK-432 group, in which 1 Klinische Einheit of OK-432 was injected into thoracic cavity after surgery. Resuts : Patients demonstrated a trend of decreased rate of prolonged air leak in the OK-432 group (2.42% vs 19.23%, p  < 0.001). After a median follow-up of 36 months (range, 2–69 months), the rate of ipsilateral pneumothorax recurrence was lower in the OK-432 group than it in control group ( p  = 0.023). OK-432 pleurodesis is the most important factor reducing the risk of recurrence (relative risk: 0.13, 95% confidence interval (CI): 0.02 to 1.03)), and prolonged air leak patients had an increased risk of recurrence (relative risk: 11.69; 95% CI: 3.41 to 40.04). Conclusion OK-432 pleurodesis after pleural abrasion can reduce the risk of recurrence. OK-432 pleurodesis is a safe and effective method for reducing the rate of postoperative air leak and ipsilateral recurrence after thoracoscopic surgery.