초록접수 현황
| 15F-098 | 구연 발표 |
Thoracoscopic pulmonary resection of secondary spontaneous pneumothorax: feasibility of cross-linked human acellular dermal matrix (Megaderm®)
Deog Gon Cho, Yong Jin Chang, Kyu Do Cho, Mi Hyung Moon, Chul Ung Kang, Min Sub Jo
Department of Thoracic and cardiovascular Surgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea
목적 : In secondary spontaneous pneumothorax (SSP), multiple, diffuse bullous lesions cause difficulties in deflation of the lung occasionally, and due to peri-stapling lung damage during thoracoscopic surgery, persistent air leakage can occur. Therefore, various methods have been performed to prevent air leakage and recurrence of pneumothorax. A novel cross-linked human acellular dermal matrix (Megaderm®) has been used in many fields as a biological tissue substitute. The objective of this study is to figure out the feasibility of Megaderm® on decreasing postoperative air leakage after thoracosccopic pulmonary resection.
방법 : From Jan, 2013 to Jul. 2015, forty five patients with SSP who had been performed thoracoscopic wedge resection were retrospectively analyzed. For Group A (31 patients), absorbable polyglycolic acid sheet (Neoveil®) and fibrin glue (Green-plast®) were covered on resection margin of the lung. For group B (14 patients), endoscopic stapler cartridge with Megaderm® attached was used for thoracoscopic wedge resection of bullous lung lesion, and resection margin was reinforced with the same method as in group A.
결과 : There were no differences on preoperative characteristics of patients in each group. There were 10 (32.3%) patients in group A and 7 (50%) patients in group B who did not have air leak on postoperative day 1. In each group, 10 (32.3%) and 4 (28.6%) patients removed chest tube on that day. Average postoperative removal of chest tube were 4.1±2.4 and 3.5±1.5 days for each group (p=0.361). There was no pneumothorax recurrence in group A. However, a patient developed pneumothorax at postoperative day 15 after hospital discharge, and was performed closed thoracostomy drainage in group B. There were no other complications in group B.
결론 : Application of cross-linked human acellular dermal matrix (Megaderm®) in thoracoscopic pulmonary resection for bullous lung disease is clinically feasible. In the future, more reliable and improved clinical data will be expected through newly designed comparative and prospective study with more patients.
방법 : From Jan, 2013 to Jul. 2015, forty five patients with SSP who had been performed thoracoscopic wedge resection were retrospectively analyzed. For Group A (31 patients), absorbable polyglycolic acid sheet (Neoveil®) and fibrin glue (Green-plast®) were covered on resection margin of the lung. For group B (14 patients), endoscopic stapler cartridge with Megaderm® attached was used for thoracoscopic wedge resection of bullous lung lesion, and resection margin was reinforced with the same method as in group A.
결과 : There were no differences on preoperative characteristics of patients in each group. There were 10 (32.3%) patients in group A and 7 (50%) patients in group B who did not have air leak on postoperative day 1. In each group, 10 (32.3%) and 4 (28.6%) patients removed chest tube on that day. Average postoperative removal of chest tube were 4.1±2.4 and 3.5±1.5 days for each group (p=0.361). There was no pneumothorax recurrence in group A. However, a patient developed pneumothorax at postoperative day 15 after hospital discharge, and was performed closed thoracostomy drainage in group B. There were no other complications in group B.
결론 : Application of cross-linked human acellular dermal matrix (Megaderm®) in thoracoscopic pulmonary resection for bullous lung disease is clinically feasible. In the future, more reliable and improved clinical data will be expected through newly designed comparative and prospective study with more patients.
책임저자: Deog Gon Cho
Department of Thoracic and cardiovascular Surgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea
연락처 : Yong Jin Chang, Tel: 010-3743-7931 , E-mail : tsmate@hanmail.net
