Pneumothorax Research Center and Division of Thoracic Surgery, Nissan Tamagawa Hospital, Tokyo, Japan.
Division of Respiratory Medicine, Faculty of Medicine, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
Eur J Cardiothorac Surg. 2023 Oct 4;64(4). doi: 10.1093/ejcts/ezad331.
Thoracic endometriosis-related pneumothorax (TERP) frequently recurs even after surgery. Meanwhile, postoperative hormonal therapies (HTx) are believed to be effective for pelvic endometriosis. Therefore, we evaluated the relationship between postoperative TERP recurrence and postoperative HTx in a retrospective observational study.
We retrospectively reviewed the data of patients with TERP who underwent the first video-assisted thoracoscopic surgery between January 2011 and February 2022.
Of the 248 patients eligible for this study, 67 (27.0%) experienced postoperative TERP recurrence. Postoperative HTx were administered to 70 patients (28.2%). Dienogest was the most frequently administered drug, given to 56.7% of patients. Following univariable analysis, postoperative hormonal therapies was closely related to reduce postoperative recurrence (P = 0.003). Likewise, the multivariable analysis revealed postoperative hormonal therapies were significantly associated with the risk reduction of recurrence (hazard ratio 0.28, P < 0.001).
Postoperative HTx reduced TERP recurrence. We hypothesize that HTx may control residual endometrial tissues to avoid TERP if pleural endometrial tissues are resected as much as possible.
即使在手术后，胸腔子宫内膜异位症相关气胸（TERP）也经常复发。同时，术后激素治疗（HTx）被认为对盆腔子宫内膜异位症有效。因此，我们在一项回顾性观察研究中评估了术后 TERP 复发与术后 HTx 之间的关系。
我们回顾性地分析了 2011 年 1 月至 2022 年 2 月期间接受首次电视辅助胸腔镜手术的 TERP 患者的数据。
在符合本研究条件的 248 名患者中，有 67 名（27.0%）发生术后 TERP 复发。70 名患者（28.2%）接受了术后 HTx。地诺孕素是最常使用的药物，56.7%的患者使用了该药物。单变量分析显示，术后 HTx 与降低术后复发密切相关（P=0.003）。同样，多变量分析显示，术后 HTx 与复发风险降低显著相关（风险比 0.28，P<0.001）。
术后 HTx 可降低 TERP 复发风险。我们假设，如果尽可能切除胸膜子宫内膜组织，HTx 可能通过控制残留的子宫内膜组织来避免 TERP。
