Maniwa Tomohiro, Nakagawa Kazuo, Isaka Mitsuhiro, Ohde Yasuhisa, Okumura Takehiro, Kondo Haruhiko
Division of Thoracic Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, Japan.
Interact Cardiovasc Thorac Surg. 2011 Sep;13(3):257-61. doi: 10.1510/icvts.2011.273201. Epub 2011 Jun 23.
Pneumothorax associated with treatment for pulmonary malignancy (PATPM) is a rare complication. Its clinicopathological features have not yet been clearly defined. Forty-one patients with PATPM from September 2002 to March 2009 were included. We evaluated the clinicopathological findings and treatment outcome of these patients. Of the 41 patients, 21 had primary lung cancer and 20 had metastatic lung tumours. Twenty-four patients (58.5%) required chest tube drainage for more than six days. Ten patients (24%) finally, received surgical treatment. Regarding the surgical procedure, conversion to open thoracotomy was required in seven (70%) of these 10 patients because of dense adhesions or anatomical changes in the thoracic cavity caused by treatment or the progression of the tumours. Two patients had severe complications after surgery. One of these two patients and another patient died of primary disease within 30 days after surgery. The median survival time in the 10 patients with surgery was 223 days (range 22-1059 days). PATPM tends to require chest tube drainage for a long period, and sometimes needs surgical treatment, which may be difficult. We should carefully identify patients who would derive considerable benefit from surgical treatment.
与肺恶性肿瘤治疗相关的气胸（PATPM）是一种罕见的并发症。其临床病理特征尚未明确界定。纳入了2002年9月至2009年3月期间的41例PATPM患者。我们评估了这些患者的临床病理结果和治疗结局。41例患者中，21例患有原发性肺癌，20例患有肺转移瘤。24例患者（58.5%）需要胸腔闭式引流超过6天。10例患者（24%）最终接受了手术治疗。关于手术操作，这10例患者中有7例（70%）因治疗或肿瘤进展导致胸腔粘连致密或解剖结构改变，需要转为开胸手术。2例患者术后出现严重并发症。这2例患者中的1例以及另1例患者在术后30天内因原发性疾病死亡。10例接受手术的患者的中位生存时间为223天（范围22 - 1059天）。PATPM往往需要长时间的胸腔闭式引流，有时需要手术治疗，而手术治疗可能具有难度。我们应仔细甄别能从手术治疗中获益显著的患者。
