Kenji Tsuboshima1, Machiko Nagata2, Teppei Wakahara2, Yasumi Matoba2, Shoichi Matsumoto3, Yoshimasa Maniwa4. 1. Department of Thoracic Surgery, Takasago Municipal Hospital, 33-1 Kamimachi, Arai Town, Takasago City, Hyogo, 676-8585, Japan. drniwatori@smn.enjoy.ne.jp. 2. Department of Thoracic Surgery, Takasago Municipal Hospital, 33-1 Kamimachi, Arai Town, Takasago City, Hyogo, 676-8585, Japan. 3. Department of Radiology, Takasago Municipal Hospital, Takasago, Japan. 4. Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Abstract
PURPOSE: In patients with primary spontaneous pneumothorax (PSP), bullae are generally resected using autosutures under video-assisted thoracoscopic surgery (VATS). However, postoperative bulla neogenesis (POBN) along the staple line is not rare and is a factor promoting PSP recurrence. POBN is attributed to tension along the staple line, and we surmise that the resected lung volume affects this tension. Therefore, in this study, we retrospectively examined the relationship between POBN and the resected lung volume in patients who underwent surgical treatment of PSP. METHODS: Between February 2011 and May 2015, 70 lung resection sites in 56 PSP patients who underwent primary VATS at our hospital were evaluated. POBN was diagnosed on high-resolution computed tomography 1 year postoperatively in principle. RESULTS: POBN was detected at 26 of 70 (37.1 %) sites. On univariate analysis, lung weight ≥1.5 g, lung length ≥4.0 cm, resected site: apical, age <25 years old and non-smoking habit were identified as significant, and the POBN rates for cases with lung weight ≥1.5 g or lung length ≥4.0 cm were 47.9 % (P = 0.004) and 44.1 % (P < 0.001), respectively. On multivariate analysis, lung weight ≥1.5 g was only significant factor for POBN (P = 0.043). CONCLUSION: A resected lung weight ≥1.5 g was only significant risk factor of POBN in patients with PSP.
PURPOSE: In patients with primary spontaneous pneumothorax (PSP), bullae are generally resected using autosutures under video-assisted thoracoscopic surgery (VATS). However, postoperative bulla neogenesis (POBN) along the staple line is not rare and is a factor promoting PSP recurrence. POBN is attributed to tension along the staple line, and we surmise that the resected lung volume affects this tension. Therefore, in this study, we retrospectively examined the relationship between POBN and the resected lung volume in patients who underwent surgical treatment of PSP. METHODS: Between February 2011 and May 2015, 70 lung resection sites in 56 PSPpatients who underwent primary VATS at our hospital were evaluated. POBN was diagnosed on high-resolution computed tomography 1 year postoperatively in principle. RESULTS: POBN was detected at 26 of 70 (37.1 %) sites. On univariate analysis, lung weight ≥1.5 g, lung length ≥4.0 cm, resected site: apical, age <25 years old and non-smoking habit were identified as significant, and the POBN rates for cases with lung weight ≥1.5 g or lung length ≥4.0 cm were 47.9 % (P = 0.004) and 44.1 % (P < 0.001), respectively. On multivariate analysis, lung weight ≥1.5 g was only significant factor for POBN (P = 0.043). CONCLUSION: A resected lung weight ≥1.5 g was only significant risk factor of POBN in patients with PSP.
Authors: Si Young Choi; Young Du Kim; Do Yeon Kim; Jong Hui Suh; Jeong Seob Yoon; Yeo Rok Kim; Eun Kyung Yu; Chan Beom Park Journal: J Thorac Dis Date: 2018-03 Impact factor: 2.895
Authors: Si Young Choi; Do Yeon Kim; Jong Hui Suh; Jeong Seob Yoon; Jin Yong Jeong; Chan Beom Park Journal: J Thorac Dis Date: 2018-07 Impact factor: 2.895