Iatrogenic pneumodesis: Gelfoam flux inoculation in focal benign cavitary lung lesion

Pulmonary air-space containing cavities signify major dissuade that hold gas exchange functions back and bring about recurrent suppuration. The aim of this work is to evaluate the impact of percutaneous local inoculation of focal benign cavitary lung lesions with synthetic material (gelfoam) guided with chest computed tomography (CT) on the patient outcome based on clinical, laboratory, functional and radiological parameters. A prospective simple randomized controlled trial was conducted on twenty eight patients with focal benign cavitary lung lesion less than 10cm in diameter in whom surgical resection was contraindicated or refused. They were subdivided into two groups: group I (medically treated): 14 patients were followed up for three months with medical prophylaxis with quinolone plus clindamycin and group II (gelfoam inoculated): 14 patients percutaneous locally injected with gelfoam under CT guidance for a single session. Gelfoam inoculated group (group II) presented more prevalence over medically treated group (group I) in the reduction of the frequency of infective exacerbations (71.42%), absence of leukocytosis (85.7%), functional improvement (42.85%), reduction of cavity size (57.14%) and cavitary obliteration (35.71%). Both groups were matched regarding the absence of hemoptysis and negative sputum cultures with high percentage (92.85%). However, reduction of the frequency of hospitalization predominated in group I. Significant statistical differences were present in radiological parameters only (reduction of size (0.042) and cavity obliteration (0.002). Success rate of procedure in the studied group was (35.71%). Percutaneous gelfoam injection may share in staged palliation and weeding out of pulmonary cavitary lesions with simple noninvasive image guided procedure.