초록접수 현황
| 16F-238 | 구연 발표 |
Suture Fixation of Polyglycolic Acid Sheet after Thoracoscopic Bullectomy in Primary Spontaneous Pneumothorax
Hyeon Jong Moon, Jae-Sung Choi, Se Jin Oh, Jeong Sang Lee, Yong Won Seong
Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
Background : Applying covering sheet over stapled line is one of the methods to decrease recurrence and have been reported to be effective and safe, but whether this covering sheet is maintained on visceral pleura or detached is rarely reported. We performed this study to identify the efficacy and safety of suture fixation of polyglycolic acid sheet(Neoveil).
Methods : From January 2013 to March 2016, a total of 105 patients underwent thoracoscopic wedge resection for primary spontaneous pneumothoraces. Ninety-six (91.4%) of the patients were male. Mean age of the patients was 25±11.7 years. There was no surgical technical difference between the patients, using three-port technique. Eighty-four (80%) patients underwent covering or suture fixation of polyglycolic acid sheet over wedge resection area. Fourty-one of them underwent suture fixation of polyglycolic acid sheet using single interrupted simple suture with 4-0 Prolene. Mechanical pleurodesis was combined in 64 (61%) of the patients.One single chest tube was inserted postoperatively in every patient.
Results : Mean hospital days after operation was 4.3±1.9 days, and mean duration of chest tube was 3.2±1.8 days. Tube size 24 inch or less was inserted in 97 (92.4%) of the patients. There were a total of 11 (10.5%) cases of recurrence, including minimal recurrence which didn’t require any treatments. Only 5 (4.8%) cases of recurrence required treatment. Patients with Neoveil covering or fixation had significantly lesser incidence of recurrence (5.9%) than patients without Neoveil (28.6%, P=0.008). Although statistically insignificant, there were no (0/41) recurrence in Neoveil fixation group compared with Neoveil covering group (5/43, P=0.055). Mechanical pleurodesis was significantly related with chronic pain (21/64, P=0.001).
Conclusion : Covering and Suture fixation of polyglycolic acid sheet both effectively and safely decreased recurrence. Neoveil fixation group had a tendency of decreased recurrence compared with Neoveil covering group. Mechanical pleurodesis is significantly related with chronic postoperative pain.
Methods : From January 2013 to March 2016, a total of 105 patients underwent thoracoscopic wedge resection for primary spontaneous pneumothoraces. Ninety-six (91.4%) of the patients were male. Mean age of the patients was 25±11.7 years. There was no surgical technical difference between the patients, using three-port technique. Eighty-four (80%) patients underwent covering or suture fixation of polyglycolic acid sheet over wedge resection area. Fourty-one of them underwent suture fixation of polyglycolic acid sheet using single interrupted simple suture with 4-0 Prolene. Mechanical pleurodesis was combined in 64 (61%) of the patients.One single chest tube was inserted postoperatively in every patient.
Results : Mean hospital days after operation was 4.3±1.9 days, and mean duration of chest tube was 3.2±1.8 days. Tube size 24 inch or less was inserted in 97 (92.4%) of the patients. There were a total of 11 (10.5%) cases of recurrence, including minimal recurrence which didn’t require any treatments. Only 5 (4.8%) cases of recurrence required treatment. Patients with Neoveil covering or fixation had significantly lesser incidence of recurrence (5.9%) than patients without Neoveil (28.6%, P=0.008). Although statistically insignificant, there were no (0/41) recurrence in Neoveil fixation group compared with Neoveil covering group (5/43, P=0.055). Mechanical pleurodesis was significantly related with chronic pain (21/64, P=0.001).
Conclusion : Covering and Suture fixation of polyglycolic acid sheet both effectively and safely decreased recurrence. Neoveil fixation group had a tendency of decreased recurrence compared with Neoveil covering group. Mechanical pleurodesis is significantly related with chronic postoperative pain.
책임저자: Yong Won Seong
Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
발표자: Yong Won Seong, E-mail : arqjoker@gmail.com