Keberhasilan Pleurodesis Bleomisin Pada Pneumotoraks Spontan Sekunder Berulang Akibat Tuberkulosis Paru: Laporan Kasus

Syazili Mustofa, Reggina Annisa Fitri, Nida Choerunnisa, Retno Ariza Soemarwoto, Giska Tri Putri, Hendri Busman

Sari


Pneumotoraks spontan sekunder merupakan komplikasi serius tuberkulosis paru dengan risiko kekambuhan yang tinggi. Dilaporkan seorang perempuan 17 tahun dengan tuberkulosis paru yang mengalami pneumotoraks berulang meskipun telah dilakukan pemasangan chest tube. Pasien kemudian menjalani pleurodesis menggunakan bleomisin, dengan hasil resolusi klinis dan radiologis lengkap tanpa kekambuhan selama 2 bulan follow-up. Temuan ini menunjukkan bahwa pleurodesis bleomisin berpotensi menjadi pilihan terapi yang efektif pada pneumotoraks spontan sekunder berulang terkait tuberkulosis, terutama pada kasus yang tidak responsif terhadap chest tube. Secara klinis, pendekatan ini dapat dipertimbangkan sebagai alternatif minimal invasif pada pasien dengan kontraindikasi tindakan bedah atau risiko kekambuhan yang tinggi.


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Pneumotoraks spontan sekunder; Pleurodesis; Hasil

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Akıncı, S. M., Soyer, T., Yalçın, Ş., Ekinci, S., Karnak, İ., Çiftçi, A. Ö., & Tanyel, F. C. (2020). The results and outcome of primary spontaneous pneumothorax in adolescents. International journal of adolescent medicine and health, 33(3), 127–131. https://doi.org/10.1515/ijamh-2018-0184

Asban, A., Raza, S. S., McLeod, C., Donahue, J., & Wei, B. (2020). Mechanical or chemical and mechanical pleurodesis for spontaneous pneumothorax: what is the most effective approach in preventing recurrence? A systematic review and meta-analysis. European Journal of Cardio-Thoracic Surgery, 58(4), 682-691..https://doi.org/10.1093/ejcts/ezaa130

British Thoracic Society. (2023). British Thoracic Society guideline for pleural disease (Vol. 78, Suppl. 3). Thorax. https://thorax.bmj.com/content/78/Suppl_3

Castaldo, N., Fantin, A., Palou-Schwartzbaum, M., Viterale, G., Crisafulli, E., Sartori, G., Aujayeb, A., Patrucco, F., & Patruno, V. (2024). Exploring the efficacy and advancements of medical pleurodesis: a comprehensive review of current research. Breathe (Sheffield, England), 20(2), 240002. https://doi.org/10.1183/20734735.0002-2024

Chan, I. C., Lee, Y. S., Chuang, C. M., & Soong, W. J. (2019). The influence of pleurodesis on the outcome of primary spontaneous pneumothorax in children. Journal of the Chinese Medical Association: JCMA, 82(4), 305–311. https://doi.org/10.1097/JCMA.0000000000000073

Chan, J. Y. H., & Lee, Y. C. G. (2020). Pleurodesis and systemic inflammatory markers: Lessons and insights. Respirology (Carlton, Vic.), 25(7), 676–677. https://doi.org/10.1111/resp.13765

Cheng, H. S., Lo, Y. T., Miu, F. P., So, L. K., & Yam, L. Y. (2023). Prevalence, risk factors, and recurrence risk of persistent air leak in patients with secondary spontaneous pneumothorax. European clinical respiratory journal, 10(1), 2168345. https://doi.org/10.1080/20018525.2023.2168345

Hallifax, R. J., Yousuf, A., Jones, H. E., Corcoran, J. P., Psallidas, I., & Rahman, N. M. (2017). Effectiveness of chemical pleurodesis in spontaneous pneumothorax recurrence prevention: a systematic review. Thorax, 72(12), 1121-1131.

Li, T., Li, Y. H., & Zhang, M. (2023). Bronchial tuberculosis with recurrent spontaneous pneumothorax: A case report. BMC pulmonary medicine, S23(1), 93. https://doi.org/10.1186/s12890-023-02374-y

Mercer, R. M., Macready, J., Jeffries, H., Speck, N., Kanellakis, N. I., Maskell, N. A., Pepperell, J., Saba, T., West, A., Ali, N., Corcoran, J. P., Hallifax, R. J., Psallidas, I., Asciak, R., Hassan, M., Miller, R. F., &

Rahman, N. M. (2020). Clinically important associations of pleurodesis success in malignant pleural effusion: Analysis of the TIME1 data set. Respirology (Carlton, Vic.), 25(7), 750–755. https://doi.org/10.1111/resp.13755

Mierzejewski, M., Korczynski, P., Krenke, R. et al. Chemical pleurodesis – a review of mechanisms involved in pleural space obliteration. Respir Res 20, 247 (2019). https://doi.org/10.1186/s12931-019-1204-x

Mustofa, S., & Antoni, A. (2023). Case Report: Unilateral Secondary Spontaneous Pneumothorax Caused by Pulmonary Tuberculosis in a Heavy Smoker. Sriwijaya Journal of Medicine, 6(3), 87-93.

Mustofa, S., Soemarwoto, R. A. S., Firdaus, E. D., Saputra, T. T., & Juhana, H. A. (2023). Penyakit Paru Obstruksi Kronis Eksaserbasi Akut dengan Pneumotoraks Spontan Sekunder. Jurnal Kedokteran Universitas Lampung, 7(1), 8-13.

Talebzadeh, H., & Nazari Sabet, M. (2023). Comparison between pleurodesis results by 50% glucose solution, versus Bleomycin pleurodesis in patients with malignant pleural effusion. International journal of physiology, pathophysiology and pharmacology, 15(5), 134–141.

van de Brekel JA, Duurkens VA, Vanderschueren RG. (1993) Pneumothorax: results of thoracoscopic talc poudrage. Chest. 103(2):345–7.

Wang, Y., Abougergi, M. S., Li, S., Patel, P., Sharma, N., & Ochieng, P. (2020). Recurrence prophylaxis in secondary spontaneous pneumothorax: A nationwide readmission database analysis. Chest, 158(6), 2474–2484

Watanabe, T., Fukai, I., Okuda, K., Moriyama, S., Haneda, H., Kawano, O., Yokota, K., Shitara, M., Tatematsu, T., Sakane, T., Oda, R., & Nakanishi, R. (2019). Talc pleurodesis for secondary pneumothorax in elderly patients with persistent air leak. Journal of Thoracic Disease, 11(1).

Wantoro, A., Mustofa, S. (2025). Sistem pakar medis. Kuningan. Penerbit Goresan Pena, 1-88.

Zablockis, R., Danila, E., Gruslys, V., & Cincilevičiūtė, G. (2021). Systemic Inflammatory Response to Different Sclerosing Agents as a Predictor of Pleurodesis Outcome. In vivo (Athens, Greece), 35(4), 2391–2398. https://doi.org/10.21873/invivo.12516




DOI: https://doi.org/10.33024/jikk.v13i3.23187

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