Kim Ji Hoon, Woo Won-Gi, Jung Yong-Ho, Moon Duk Hwan, Lee Sungsoo
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
J Chest Surg. 2024 Sep 5;57(5):484-489. doi: 10.5090/jcs.24.021. Epub 2024 Aug 8.
Catamenial pneumothorax (CP) is a rare form of spontaneous pneumothorax that is linked to endometriosis; thus, it predominantly manifests in women of reproductive age. Considerable research has explored the potential benefits of postoperative hormone therapy following various surgical interventions. This study was performed to examine the clinical implications of postoperative hormone treatment in patients with CP.
The study included patients who underwent surgical intervention for CP between November 2009 and February 2023. These procedures included wedge resection, diaphragm resection, and total pleural coverage. Recurrence-free survival was analyzed using the Kaplan-Meier log-rank test to assess the impact of hormone therapy. Additionally, Cox proportional hazards analysis was employed to identify risk factors associated with postoperative CP recurrence.
The study included 41 patients, with a median age of 38.4 years. Among them, 27 individuals received hormone therapy, 8 of whom experienced recurrence during a median follow-up period of 1 year. Patients who received hormone therapy exhibited a lower rate of recurrence than those who did not; however, the difference was not statistically significant, likely due to the small sample size. Side effects of hormone therapy included depression (6.8%), excessive sweating (3.4%), and headache (3.4%). In the analysis of risk factors for postoperative recurrence, diaphragm resection emerged as a protective factor (hazard ratio, 0.16; 95% confidence interval, 0.03-0.77; p=0.022).
Hormone treatment combined with surgery did not significantly impact recurrence in patients with CP. The application of diaphragm resection was the sole factor that displayed significance in preventing CP recurrence.
月经性气胸（CP）是一种与子宫内膜异位症相关的罕见的自发性气胸形式，因此主要发生在育龄女性中。大量研究探讨了各种手术干预后术后激素治疗的潜在益处。本研究旨在探讨CP患者术后激素治疗的临床意义。
该研究纳入了2009年11月至2023年2月期间接受CP手术干预的患者。这些手术包括楔形切除术、膈肌切除术和全胸膜覆盖术。使用Kaplan-Meier对数秩检验分析无复发生存率，以评估激素治疗的影响。此外，采用Cox比例风险分析来确定与术后CP复发相关的风险因素。
该研究纳入了41例患者，中位年龄为38.4岁。其中，27例接受了激素治疗，其中8例在中位随访期1年期间复发。接受激素治疗的患者复发率低于未接受激素治疗的患者；然而，由于样本量小，差异无统计学意义。激素治疗的副作用包括抑郁（6.8%）、多汗（3.4%）和头痛（3.4%）。在术后复发风险因素分析中，膈肌切除术是一个保护因素（风险比，0.16；95%置信区间，0.03-0.77；p=0.022）。
激素治疗联合手术对CP患者的复发没有显著影响。膈肌切除术的应用是预防CP复发的唯一具有显著意义的因素。
