Noda Masafumi, Okada Yoshinori, Maeda Sumiko, Sado Tetsu, Sakurada Akira, Hoshikawa Yasushi, Endo Chiaki, Kondo Takashi
Department of Thoracic Surgery, Institute of Development, Aging, and Cancer, Tohoku University, Sendai, Japan.
Ann Thorac Cardiovasc Surg. 2010 Dec;16(6):439-41.
We present a case of bilateral intractable pneumothorax associated with a modified form of lymphangioleiomyomatosis (LAM), successfully treated with a previously reported surgical procedure, the total pleural covering (TPC) technique, under video-assisted thoracic surgery. The patient was a 28-year-old woman with bilateral pneumothorax secondary to LAM who had undergone thoracoscopic surgery in another hospital. We performed bilateral TPC modified with a preceding coverage of air leak points with polyglycolic acid sheets for reinforcement. Although a minor air leak after the surgery necessitated a mild pleurodesis on the right side, the bilateral pneumothorax was well controlled, and no recurrence has been observed for 9 months. We believe that TPC is a safe and reliable procedure for the management of intractable pneumothorax secondary to LAM. It also has the potential to reduce risk of excessive bleeding in lung transplantation.
我们报告一例与改良型淋巴管平滑肌瘤病（LAM）相关的双侧难治性气胸病例，该病例在电视辅助胸腔镜手术下采用先前报道的手术方法——全胸膜覆盖（TPC）技术成功治疗。患者为一名28岁女性，因LAM继发双侧气胸，曾在另一家医院接受过胸腔镜手术。我们采用聚乙醇酸片预先覆盖漏气点进行强化，对双侧TPC进行了改良。尽管术后右侧出现轻微漏气，需要进行轻度胸膜固定术，但双侧气胸得到了良好控制，9个月来未观察到复发。我们认为TPC是治疗LAM继发难治性气胸的一种安全可靠的方法。它还有可能降低肺移植中出血过多的风险。
