Asano Hisatoshi, Ohtsuka Takashi, Noda Yuki, Kato Daiki, Mori Shohei, Nakada Takeo, Matsudaira Hideki
Division of Thoracic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
J Thorac Dis. 2019 May;11(5):1940-1944. doi: 10.21037/jtd.2019.04.105.
Recurrence of pneumothorax after thoracoscopic surgery is a concerning issue for thoracic surgeons. In this study, we aimed to determine the risk factors for recurrence of spontaneous pneumothorax after thoracoscopic surgery.
A total of 192 patients with spontaneous pneumothorax aged <50 years who underwent thoracoscopic surgery from January 2010 to December 2016 were included in this study. Pre- and post-operative characteristics were obtained from medical records, and recurrent and non-recurrent cases were compared.
Fourteen patients (7.3%) experienced pneumothorax recurrence. Pneumothorax recurrence was observed more frequently in patients aged <20 years (P=0.041) and those in whom bullae were not identified on preoperative computed tomography (CT) (P=0.049). The use of polyglycolic acid (PGA) sheets during surgery significantly decreased the recurrence rate (P=0.031). A history of ipsilateral pneumothorax before surgery was a significant risk factor for recurrence after thoracoscopic surgery (P=0.001). In the multivariate analysis, a history of ipsilateral pneumothorax and identification of bullae on CT were identified as significant risk factors for recurrence.
A history of ipsilateral pneumothorax, and inability to identify bullae on preoperative CT were risk factors for postoperative recurrence of pneumothorax.
胸腔镜手术后气胸复发是胸外科医生关注的问题。在本研究中，我们旨在确定胸腔镜手术后自发性气胸复发的危险因素。
本研究纳入了2010年1月至2016年12月期间接受胸腔镜手术的192例年龄<50岁的自发性气胸患者。从病历中获取术前和术后特征，并比较复发和未复发病例。
14例患者（7.3%）出现气胸复发。<20岁的患者（P=0.041）以及术前计算机断层扫描（CT）未发现肺大疱的患者（P=0.049）气胸复发更为常见。手术期间使用聚乙醇酸（PGA）片显著降低了复发率（P=0.031）。术前同侧气胸病史是胸腔镜手术后复发的重要危险因素（P=0.001）。在多变量分析中，同侧气胸病史和CT上肺大疱的识别被确定为复发的重要危险因素。
同侧气胸病史和术前CT无法识别肺大疱是气胸术后复发的危险因素。
