Necessity of Multi-Step Surgical Treatment for Patients with Interstitial Lung Disease and a Pneumothorax.

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic and Cardiovascular Surgery Pub Date : 2022-10-20 Epub Date: 2022-08-02 DOI:10.5761/atcs.oa.22-00087

Akira Iyoda, Yoko Azuma, Takashi Sakai, Satoshi Koezuka, Hajime Otsuka, Atsushi Sano

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Abstract

Purpose: A pneumothorax occurs in 3%-8% of patients with idiopathic pulmonary fibrosis. A pneumothorax may predict a poor outcome in patients with interstitial lung disease (ILD), and it is difficult to treat patients with ILD and a pneumothorax.

Patients and methods: We retrospectively studied data from all 12 patients with ILD and a pneumothorax who underwent surgical treatment at Toho University Omori Medical Center Hospital between 2009 and 2021.

Results: Of the 12 patients, 2 had home oxygen therapy preoperatively and were classified with grade IV interstitial pneumonia (IP). Six patients had preoperative pleurodesis and two had postoperative one using auto-blood. Three patients (25%) had multi-step surgery ≥2, and 5 patients had surgical resection of bullae. No patients had postoperative acute exacerbations and all were discharged from the hospital in a stable condition. The 5-year overall survival rate for all patients was 70.0%. The median survival time was not reached. One patient with unclassified IP was doing well 116 months after surgery.

Conclusion: Patients with ILD and a pneumothorax were shown to require multi-step surgical treatment and can anticipate long-term survival.

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间质性肺疾病合并气胸患者多步骤手术治疗的必要性。

目的:3%-8%的特发性肺纤维化患者发生气胸。气胸可能预示间质性肺疾病(ILD)患者预后较差，并且很难治疗间质性肺疾病合并气胸的患者。患者和方法:我们回顾性研究了2009年至2021年间在东宝大学大森医学中心医院接受手术治疗的所有12例ILD合并气胸患者的数据。结果:12例患者中2例术前行家庭吸氧治疗，均为IV级间质性肺炎(IP)。术前行胸膜穿刺术6例，术后行自体血穿刺术1例。3例(25%)患者行≥2步手术，5例行大疱切除术。术后无急性加重，出院时病情稳定。所有患者5年总生存率为70.0%。中位生存时间未达到。一名未分类IP患者在手术后116个月恢复良好。结论:ILD合并气胸的患者需要多步骤的手术治疗，并且可以预期长期生存。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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