Subotic D, Mikovic Z, Atanasijadis N, Savic M, Moskovljevic D, Subotic D
Clinic for thoracic surgery, Clinical Center of Serbia, Belgrade, Serbia.
University of Belgrade School of medicine, Belgrade, Serbia.
J Cardiothorac Surg. 2016 Apr 14;11(1):66. doi: 10.1186/s13019-016-0462-7.
Our recent clinical observations put into question the routine hormonal therapy for pneumothorax recurrence prevention, in patients operated for catamenial pneumothorax (CP).
Retrospective review of the treatment of four women operated for CP in a recent 32-months period.
The four presented patients with CP represent 4.8 % of the overall number of patients operated for spontaneous pneumothorax and 19 % of women operated for pneumothorax in the same period. In all patients, typical multiple diaphragm holes existed. The involved part of the diaphragm was removed with diaphragm suture in three patients, whilst in one patient, a diaphragm placation was done. Endometriosis was histologically confirmed in two patients. During the follow-up period of 6-43 months, none of the patients underwent a postoperative hormonal therapy for different reasons, and in none of them the pneumothorax recurrence occurred.
The clinical course of these patients, with the absence of the pneumothorax recurrence despite the omission of the hormonal treatment, suggests that the appropriateness of the routine hormonal treatment with gonadotrophin-releasing hormone analogues for 6-12 months, should be reconsidered and re-evaluated in further studies.
我们最近的临床观察对经手术治疗月经性气胸（CP）的患者预防气胸复发的常规激素疗法提出了质疑。
回顾性分析最近32个月内4例接受CP手术治疗的女性患者的治疗情况。
这4例CP患者占同期接受自发性气胸手术患者总数的4.8%，占同期接受气胸手术女性患者的19%。所有患者均存在典型的多发性膈肌孔。3例患者采用膈肌缝合术切除受累的膈肌部分，1例患者进行了膈肌折叠术。2例患者经组织学证实患有子宫内膜异位症。在6至43个月的随访期内，所有患者均因不同原因未接受术后激素治疗，且无一例发生气胸复发。
这些患者的临床病程显示，尽管未进行激素治疗但气胸未复发，这表明应在进一步研究中重新考虑和评估常规使用促性腺激素释放激素类似物进行6至12个月激素治疗的合理性。
