Masaki Ikeda1, Koji Takahashi2, Teruya Komatsu2, Toru Tanaka3, Tatsuo Kato4, Takuji Fujinaga5. 1. Department of Thoracic Surgery, Nagara Medical Center, Nagara 1300-7, Gifu, 502-8558, Japan. imsk581107@gmail.com. 2. Department of Thoracic Surgery, Kyoto University Graduate School, Kyoto, Japan. 3. Department of Thoracic Surgery, Kansai Electric Power Hospital, Osaka, Japan. 4. Department of Respiratory Medicine, Nagara Medical Center, Gifu, Japan. 5. Department of Thoracic Surgery, Nagara Medical Center, Nagara 1300-7, Gifu, 502-8558, Japan.
Abstract
OBJECTIVES: Characteristics of pneumothorax associated with nontuberculous mycobacterium (NTM) infection are rarely reported, especially in terms of surgical treatments. Our objectives were to show the tendency and clinical courses of pneumothorax due to NTM and discuss the way of therapy in our hospital. METHODS: We retrospectively analyzed 557 patients with NTM infection over a period of 5 years at the Nagara Medical Center. RESULTS: A total of 12 out of the 557 patients (2.2%) suffered from pneumothorax caused by NTM infection without other pulmonary diseases. The diagnosis of all NTM cases was mycobacterium avium complex. Of these 12 patients, three required observation only (25%), five required drainage only (42%), and four required surgery after drainage (33%). The four surgically treated patients suffered from empyema as well as pneumothorax. They were in worse nutritional condition than non-surgically treated patients. For the patients requiring surgery, we selected reasonable surgical methods; we sutured the fistula of lung in all cases and covered it with muscle or omentum or polyglycolic acid sheets without a case in which endobronchial embolization was performed in advance before surgery. Finally, all pneumothorax healed. Thereafter, three of these four patients took unfavorable courses: progressing malnutrition, complications worsening or contralateral pneumothorax. CONCLUSION: We should select an appropriate treatment including surgery against NTM-associated pneumothorax without losing an opportunity because of its intractability and exhausting effect.
OBJECTIVES: Characteristics of pneumothorax associated with nontuberculous mycobacterium (NTM) infection are rarely reported, especially in terms of surgical treatments. Our objectives were to show the tendency and clinical courses of pneumothorax due to NTM and discuss the way of therapy in our hospital. METHODS: We retrospectively analyzed 557 patients with NTM infection over a period of 5 years at the Nagara Medical Center. RESULTS: A total of 12 out of the 557 patients (2.2%) suffered from pneumothorax caused by NTM infection without other pulmonary diseases. The diagnosis of all NTM cases was mycobacterium avium complex. Of these 12 patients, three required observation only (25%), five required drainage only (42%), and four required surgery after drainage (33%). The four surgically treated patients suffered from empyema as well as pneumothorax. They were in worse nutritional condition than non-surgically treated patients. For the patients requiring surgery, we selected reasonable surgical methods; we sutured the fistula of lung in all cases and covered it with muscle or omentum or polyglycolic acid sheets without a case in which endobronchial embolization was performed in advance before surgery. Finally, all pneumothorax healed. Thereafter, three of these four patients took unfavorable courses: progressing malnutrition, complications worsening or contralateral pneumothorax. CONCLUSION: We should select an appropriate treatment including surgery against NTM-associated pneumothorax without losing an opportunity because of its intractability and exhausting effect.
Authors: J Ignacio de Ulíbarri; A González-Madroño; N G P de Villar; P González; B González; A Mancha; F Rodríguez; G Fernández Journal: Nutr Hosp Date: 2005 Jan-Feb Impact factor: 1.057
Authors: David E Griffith; Timothy Aksamit; Barbara A Brown-Elliott; Antonino Catanzaro; Charles Daley; Fred Gordin; Steven M Holland; Robert Horsburgh; Gwen Huitt; Michael F Iademarco; Michael Iseman; Kenneth Olivier; Stephen Ruoss; C Fordham von Reyn; Richard J Wallace; Kevin Winthrop Journal: Am J Respir Crit Care Med Date: 2007-02-15 Impact factor: 21.405