초록접수 현황
| 16F-172 | 구연 발표 |
Factors Related to Contralateral Recurrence of Primary Spontaneous Pneumothorax
Yong Jin Chang, Deog Gon Cho, Kyu Do Cho, Chul Ung Kang, Min Sub Jo
Department of Thoracic and cardiovascular Surgery, St. Vincent`s Hospital, The Catholic University College of Medicine, Gyeonggi-do, Korea
Background : More than half of the patients with unilateral primary spontaneous pneumothorax(PSP) have contralateral bulla. However, surgical procedure is not followed among the patients with asymptomatic and no pneumothorax in contralateral bulla. The aim of this study is to figure out the risk factors of contralateral recurrence in the unilateral PSP who have bilateral bulla.
Methods : The database is consisted of 323 unilateral PSP with first episode from January 2011 to May 2015. The following data was included: the patient’s characteristic, including height, BMI, Haller index; the findings of Chest X-ray and HRCT to see the bulla; and the surgical procedures, closed thoracostomy or VATS.
Results : For the first episode of pneumothorax, 94 patients received closed thoracostomy; while 229 patients undergone unilateral VATS. Recurrence was occurred in 85 among 323 patients (26.3%); and surprisingly, 43 (50.6%) had contralateral recurrence among the patients. The patients who had closed thoracostomy was 9 among 94 patients (9.6%); while the patients who undergone unilateral VATS was 34 among 229 patients (14.8%) (p<0.001). The number of patients with bilateral bulla was 155 among 323 patients (54.2%); The contralateral recurrence was shown in 38 (24.5%) among the patients. Patients who scores more than 2.7 Haller index were 171 patients (53.2%), and among those patients, 26 (15.2%) had contralateral recurrence. The risk factors for contralateral recurrence was following: bilateral bulla (HR, 2.774,p=0.001), unilateral VATS (HR, 5.189, p=0.016), Haller index(>2.7, HR, 5.798, p=0.047).
Conclusion : The concomitant bilateral VATS can be considered in the particular unilateral PSP with chest depressive deformity and bilateral bulla. From this study, we make a hypothesis that the anesthetic factors in one lung ventilation including tidal volume and airway pressure may affect the contralateral lung during the previous surgery. We suggest that more studies have to be done on the correlation of one lung ventilation and contralateral bulla,
Methods : The database is consisted of 323 unilateral PSP with first episode from January 2011 to May 2015. The following data was included: the patient’s characteristic, including height, BMI, Haller index; the findings of Chest X-ray and HRCT to see the bulla; and the surgical procedures, closed thoracostomy or VATS.
Results : For the first episode of pneumothorax, 94 patients received closed thoracostomy; while 229 patients undergone unilateral VATS. Recurrence was occurred in 85 among 323 patients (26.3%); and surprisingly, 43 (50.6%) had contralateral recurrence among the patients. The patients who had closed thoracostomy was 9 among 94 patients (9.6%); while the patients who undergone unilateral VATS was 34 among 229 patients (14.8%) (p<0.001). The number of patients with bilateral bulla was 155 among 323 patients (54.2%); The contralateral recurrence was shown in 38 (24.5%) among the patients. Patients who scores more than 2.7 Haller index were 171 patients (53.2%), and among those patients, 26 (15.2%) had contralateral recurrence. The risk factors for contralateral recurrence was following: bilateral bulla (HR, 2.774,p=0.001), unilateral VATS (HR, 5.189, p=0.016), Haller index(>2.7, HR, 5.798, p=0.047).
Conclusion : The concomitant bilateral VATS can be considered in the particular unilateral PSP with chest depressive deformity and bilateral bulla. From this study, we make a hypothesis that the anesthetic factors in one lung ventilation including tidal volume and airway pressure may affect the contralateral lung during the previous surgery. We suggest that more studies have to be done on the correlation of one lung ventilation and contralateral bulla,
책임저자: Deog Gon Cho
Department of Thoracic and cardiovascular Surgery, St. Vincent`s Hospital, The Catholic University College of Medicine, Gyeonggi-do, Korea
발표자: Yong Jin Chang, E-mail : tsmate@hanmail.net