Pleural Coating by 50% Glucose Solution Reduces Postoperative Recurrence of Spontaneous Pneumothorax

Tsuboshima, Kenji; Wakahara, Teppei; Matoba, Yasumi; Maniwa, Yoshimasa

doi:10.1016/j.athoracsur.2018.02.040

Cited by 10 publications

(10 citation statements)

References 15 publications

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“…Our study revealed the margin distance ≥5.0 mm as the significant factor preventing postoperative recurrence for PSP. It was thought that age and smoking habit affected postoperative recurrence (1,2,4). The margin distance is a factor that could be controlled by thoracic surgeons intraoperatively, unlike age and past smoking habit that we could not control.…”

Section: Discussionmentioning

confidence: 82%

“…Nevertheless, postoperative recurrence was relatively common regardless of these reinforcements (1.22-14.2%) (1)(2)(3)(4)(5)(6). Therefore, a different viewpoint to resolve this problem was necessary.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the retrospective nature of our study, the patient backgrounds were heterogeneous. Recently, for a retrospective study, the IPTW method by propensity score was used to adjust patient backgrounds (1,14,17). Hence, we also used the IPTW method to evaluate the relationship between the margin distance and the postoperative recurrence, in addition to the Kaplan-Meier method and Cox regression analysis.…”

Section: Discussionmentioning

confidence: 99%

“…For primary spontaneous pneumothorax (PSP), videoassisted thoracoscopic surgery (VATS) bullectomy using autosutures is the standard surgical procedure (1)(2)(3)(4). Although various procedures, such as visceral pleural reinforcement by absorbable covering sheet, chemical, or mechanical pleurodesis, to prevent postoperative recurrence of PSP have been performed, it remains relatively high (1)(2)(3)(4)(5)(6). Therefore, a different viewpoint to resolve this problem is necessary.…”

Section: Introductionmentioning

confidence: 99%

“…Depending on the surgeon's preference, fragility of the lung, presence of air leakage during surgery, covering materials and fibrin glue were selected. If there were no clear findings of intrathoracic infection, a pleural coating using 50% glucose was performed, as we previously described, to reduce postoperative recurrence (1). After placing a chest tube in the intrathoracic cavity, the wound was closed.…”

mentioning

confidence: 99%

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Optimal margin distance of bullectomy for primary spontaneous pneumothorax reduces postoperative recurrence

Tsuboshima¹,

Matoba²,

Wakahara³

2019

J Thorac Dis

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Background: For primary spontaneous pneumothorax, bullectomy using autosutures is the standard procedure. Despite performing various methods for preventing postoperative recurrence, it remains relatively high. Although considering the margin distance of bullectomy is important, no argument has been discussed for the optical margin distance until now. Hence, we evaluated the optimal margin distance for bullectomy of spontaneous pneumothorax, bullectomy to reduce postoperative recurrence. Methods: Between March 2015 and May 2018, 91 eligible candidates from 142 cases, who underwent video-assisted thoracoscopic bullectomy for spontaneous pneumothorax, bullectomy, were evaluated. We analysed the factors preventing postoperative recurrence, including the margin distance using the inverseprobability of treatment weighted method by propensity score was used to adjust for heterogeneous patient backgrounds. Results: The patients' median age was 20 years (range, 14-86 years). Postoperative recurrences occurred in 8 cases (8.8%). The margin distance was 9.1±5.0 mm. The cut-off point of the margin distance was defined as 5.0 mm. The inverse-probability of treatment weighted method indicated that a margin distance ≥5.0 mm significantly prevented postoperative recurrence (P=0.0076, hazard ratio =0.18).Conclusions: This study suggests that a margin distance of ≥5.0 mm for bullectomy of PSP can reduce postoperative recurrence.

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Section: Discussionmentioning

confidence: 82%