The Journal of the Japanese Association for Chest Surgery
Online ISSN : 1881-4158
Print ISSN : 0919-0945
ISSN-L : 0919-0945
Surgical treatment for secondary pneumothorax in patients with interstitial pneumonia
Shinji NakashimaMakoto HashimotoHitoki HashiguchiMayuko UeharaYousuke KurodaTaijirou MishinaRyou HaradaKazutoshi TachibanaSyunsuke OhoriTakuro ObamaAtsushi WatanabeTetsuya Higami
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2010 Volume 24 Issue 4 Pages 658-663

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Abstract
Problems in surgical treatment for secondary pneumothorax in patients with interstitial pneumonia (IP) include not only difficulty in repairing the pleural fistula but also the fact that the surgery itself can be fatal because of chronic steroid use and a severely impaired lung function. We report eight patients with intractable pneumothorax with IP who were treated mainly by video-assisted thoracoscopic surgery (VATS) in our institution. The patients comprised 6 men and 2 women (average age: 65 years), in whom 3 patients required continuous oxygen inhalation therapy, 4 had concurrent collagen disease, and 5 patients were given steroids preoperatively. One patient with bilateral pneumothorax underwent bilateral VATS repairs simultaneously. Three patients underwent open thoracotomy for air leak repair, and one of these three patients underwent pedicled omentopexy for intractable pneumothorax and empyema caused by methicillin-resistant Staphylococcus aureus (MRSA). Four patients required mechanical ventilation postoperatively. Two patients (25%) died due to postoperative respiratory failure caused by the exacerbation of IP. Difficulties in the intra- and postoperative management of the respiratory disorder resulted in these deaths.
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© 2010 The Japanese Association for Chest Surgery
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