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2013 | 85 | 1 | 12-19
Tytuł artykułu

Treatment of Recurrent Primary Spontaneous Pneumothorax – Own Experience

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Primary spontaneous pneumothorax could be a serious therapeutic problem in case of recurrence. Lack of therapeutic standards sometimes leads to delay in definitive surgical treatment and could cause respiratory complications. The aim of the studywas the evaluation of treatment results in patients with recurrence of primary spontaneous pneumothorax and looking for optimal therapeutic method after first recurrence (surgical treatment vs. pleural drainage). Material and methods.Between 01.01.2009 and 31.07.2010 fifty four patients with recurrent primary spontaneous pneumothorax was hospitalized in Wrocław Thoracic Surgery Centre (24.3% of all patients with pneumothorax). The recurrence was treated surgically in 24 cases, in 30 pleural drainage was performed: simple drainage (n=14) or drainage with chemical pleurodesis (n=16). Mean age of patients treated without surgery was higher than surgically treated (p=0,012). Results.In surgery group no recurrence was found, in drainage group 11 recurrences occurred (p=0.0009). In group of 11 patients with second recurrence, pleurodesis was performed four times (36%) vs. 12 times (63%) in 19 patients without a recurrence of the disease. 70% of non-surgically treated patients vs. 50% of surgically treated were afraid of recurrence (p=0.01). Among 11 patients in drainage group, nine underwent surgery at the second episode of recurrence. Conclusions.The optimal treatment method in case of first recurrence of primary spontaneous pneumothorax is surgical treatment. When it is not possible chemical pleurodesis should be performed during pleural drainage. Most of the patients after second recurrence are treated surgically anyway. The surgical treatment significantly reduces patient’s fears for future recurrence of the disease. Younger patients are most often surgically treated.
Wydawca

Rocznik
Tom
85
Numer
1
Strony
12-19
Opis fizyczny
Daty
wydano
2013-01-01
online
2013-03-16
Twórcy
  • Department of Thoracic Surgery, Lower Silesian Centre of Lung Diseases in Wrocław, Ordynator: dr n. med. M. Marciniak
  • Department of Thoracic Surgery, Lower Silesian Centre of Lung Diseases in Wrocław, Ordynator: dr n. med. M. Marciniak
  • Department of Thoracic Surgery, Medical University in Wrocław, Kierownik: dr n. med. M. Marciniak
  • Department of Thoracic Surgery, Lower Silesian Centre of Lung Diseases in Wrocław, Ordynator: dr n. med. M. Marciniak
  • Department of Thoracic Surgery, Medical University in Wrocław, Kierownik: dr n. med. M. Marciniak
  • Department of Thoracic Surgery, Lower Silesian Centre of Lung Diseases in Wrocław, Ordynator: dr n. med. M. Marciniak
  • Department of Thoracic Surgery, Medical University in Wrocław, Kierownik: dr n. med. M. Marciniak
  • Department of Thoracic Surgery, Lower Silesian Centre of Lung Diseases in Wrocław, Ordynator: dr n. med. M. Marciniak
  • Department of Thoracic Surgery, Medical University in Wrocław, Kierownik: dr n. med. M. Marciniak
Bibliografia
  • 1. Sadicot RT , Greene T, Meadows K et al.: Recurrence of primary spontaneous pneumothorax. Thorax 1997; 52: 805-09.
  • 2. Gawrychowski J, Filipowski M: Wybór sposobu leczenia chorych z tzw. odmą opłucnej w świetle aktualnych poglądów. Pneumonol Alergol Pol 1994; 62: 317-32.
  • 3. Pawłowicz A, Droszcz W: Idiopatyczna odma opłucnej. Pneumonol Pol 1986; 54: 77-80.
  • 4. Primrose WR : Spontaneous pneumothorax: a retrospective review of aetiology, pathogenesis and management. Scott Med J 1984; 29: 15-20.
  • 5. Giles Beauchamp: Spontaneous pneumothorax and pneumomediastinum. Thoracic surgery. Pearson FG, Hiebert CA, Deslaurriers Jiwsp. Churchill Livingstone, New York 1995; 1037-54.
  • 6. Otto T: Odma samorodna. Pneumonol Pol 1986; 54: 41-44.
  • 7. Jain SK, Al-Kattan KM , Hamdy MG: Spontaneous pneumothorax: determinants of surgical intervention. J Cardiovasc Surg 1998; 39: 107-11.
  • 8. Pryt Ł: Videotorakoskopia jako alternatywna metoda leczenia odmy samoistnej. Wideochirurgia 1997; 3: 25-27.
  • 9. Chudański M: Odma opłucnowa. Etiopatogeneza i leczenie - współczesne poglądy. Pneumonol AlergolPol 2000; 68: 76-82.
  • 10. Czyżewski K, Gawrychowski J, Rokicki J i wsp.: Powtarzane nakłucia i całkowita pleurektomia ścienna w leczeniu chorych z pierwotną odmą opłucnej. Pneumonol Alergol Pol 1998; 66: 265-64.
  • 11. Lipka M, Gawrychowski J, Rokicki M i wsp.: Powtarzane nakłucia i całkowita pleurektomia ścienna w leczeniu chorych z pierwotną odmą opłucnej - wyniki odległe. Pneumonol Alergol Pol 1998; 66: 265-70.
  • 12. Rokicki M, Rokicki W: O sposobach leczenia samoistnej pierwotnej (idiopatycznej) odmy opłucnowej. Pneumonol Alergol Pol 2005; 73: 202-06.
  • 13. Harvey J, Prescott RJ: Simple aspiration versus intercostal tube drainage for spontaneous pneumothorax in patients with normal lungs. BMJ 1994; 309: 1338-39.
  • 14. Osaki T, Nakahashi H, Horiuchi Y et al.: Evaluation of surgical treatment of spontaneous pneumothorax- assessment of postoperative recurrence and quality of life. Nippon Kyobu Geka Zasshi 1992; 40: 80-85.
  • 15. Young LR , Almoosa KF, Pollock-Barziv S et al.: Patent perspectives on management of pneumothorax in lymphangioleiomyomatosis. Chest 2006; 129:1267-73.
  • 16. Chou SH. Cheng YJ. Kao EL : Is video-assisted thoracic surgery indicated in the first episode primary spontaneous pneumothorax? Interact CardiovascThorac Surg 2003; 2: 552-54.
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_pjs-2013-0003
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