The Annals of Thoracic Surgery, Vol 28, 146-150, Copyright © 1979 by The Society of Thoracic Surgeons
Intrapleural instillation of quinacrine for treatment of recurrent spontaneous pneumothorax
AJ Larrieu, GF Tyers, EH Williams, MJ O'Neill and JR Derrick
We used intrapleural instillation of quinacrine hydrochloride in 20
patients (Group A) with recurrent spontaneous pneumothorax (one bilateral)
and compared their clinical course with 19 patients who underwent
thoracotomy and scarification or pleurectomy (Group B) and 63 patients
treated by tube thoracostomy alone (Group C). In Group A, there was one
complication of treatment, a pneumothorax immediately following tube
removal, which necessitated repeat tube thoracostomy, and there was one
late ipsilateral recurrence 2 years after treatment. These 20 patients with
21 recurrent spontaneous pneumothoraces treated with intrapleurally
administered quinacrine have been followed for from 6 months to more than 4
years with only one late recurrence on the treated side. Eight patients in
Group B had postoperative complications: 2 patients who had had pleurectomy
required reoperation for postoperative bleeding; lobar pneumonia developed
in 3; 1 had lack of total expansion of the lung; an intrathoracic hematoma
developed in 1; and an ipsilateral pneumothorax necessitating tube
thoracostomy developed in 1. In Group C, the rate of recurrence of
pneumothorax was 23% during the first year following treatment.
Intrapleural instillation of quinacrine is a simple, low-risk, reliable,
and effective treatment for recurrent spontaneous pneumothorax, and is
equally as effective as thoracotomy and scarification.
