月经性气胸作为胸壁子宫内膜异位症综合征和盆腔子宫内膜异位症的首发表现
Catamenial Pneumothorax as the First Expression of Thoracic Endometriosis Syndrome and Pelvic Endometriosis.
作者信息
Ciriaco Paola, Muriana Piergiorgio, Carretta Angelo, Ottolina Jessica, Candiani Massimo, Negri Giampiero
机构信息
Department of Thoracic Surgery, Scientific Institute and University Vita-Salute San Raffaele, Hospital San Raffaele Milano, 20132 Milan, Italy.
Department of Obstetrics and Gynecology, Scientific Institute and University Vita-Salute San Raffaele, Hospital San Raffaele Milano, 20132 Milan, Italy.
出版信息
J Clin Med. 2022 Feb 23;11(5):1200. doi: 10.3390/jcm11051200.
OBJECTIVE
The menstrual-related catamenial pneumothorax (CP) can be the first expression of thoracic endometriosis syndrome (TES), which is the presence of endometriotic lesions in the lungs and pleura, and pelvic endometriosis (PE). This study aims to analyze our experience with this specific correlation describing our multidisciplinary approach to CP.
METHODS
Hospital records of 32 women, operated for CP at our Department from January 2001 to December 2021 were reviewed. Surgical treatment consisted of videothoracoscopy and laparoscopy when indicated.
RESULTS
TES and PE were diagnosed in 13 (40.6%) and 12 (37.5%) women, respectively. The association of TES and PE was present in 11 cases (34%). Fifteen patients (46.9%) underwent laparoscopy, of which 11 concurrently with videothoracoscopy. Most of the patients affected had stage III-IV endometriosis (40.6%). All patients received hormonal therapy after surgery. Five patients with PE conceived spontaneously resulting in six live births. The mean follow-up was 117 ± 71 months (range 8-244). Pneumothorax recurrence occurred in six patients (18.8%). At present, all women are asymptomatic, with no sign of pneumothorax recurrence.
CONCLUSIONS
CP might be the first expression of TES and/or PE. A multidisciplinary approach is advocated for optimal management of the disease.
目的
与月经相关的经期气胸（CP）可能是胸内子宫内膜异位症综合征（TES）的首发表现，胸内子宫内膜异位症综合征指肺部和胸膜存在子宫内膜异位病变，同时伴有盆腔子宫内膜异位症（PE）。本研究旨在分析我们在这种特定关联方面的经验，并描述我们对CP的多学科治疗方法。
方法
回顾了2001年1月至2021年12月在我院接受CP手术的32名女性的医院记录。手术治疗包括在有指征时进行电视胸腔镜检查和腹腔镜检查。
结果
分别在13名（40.6%）和12名（37.5%）女性中诊断出TES和PE。11例（34%）患者同时存在TES和PE。15名患者（46.9%）接受了腹腔镜检查，其中11名同时进行了电视胸腔镜检查。大多数受影响患者患有III-IV期子宫内膜异位症（40.6%）。所有患者术后均接受了激素治疗。5名患有PE的患者自然受孕，共分娩6名活婴。平均随访时间为117±71个月（范围8-244个月）。6名患者（18.8%）出现气胸复发。目前，所有女性均无症状，无气胸复发迹象。
结论
CP可能是TES和/或PE的首发表现。提倡采用多学科方法对该疾病进行最佳管理。
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