European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025
The Safety and Efficacy of Secondary Spontaneous Pneumothorax Surgery: Especially in Interstitial Lung Disease and Chronic Obstructive Pulmonary Disease.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Adachi Taishi, Omasa Mitsugu, Takehara Ren, Nakanishi Takao, Motoyama Hideki
Аннотация
OBJECTIVES: To clarify the surgical indications for secondary spontaneous pneumothorax (SSP), we compared the outcomes between interstitial lung disease (ILD)- and chronic obstructive pulmonary disease (COPD)-associated SSP using propensity score matching (PSM) and identified the risk factors for recurrence, prolonged air leakage (PAL), and postoperative complications.
METHODS: We retrospectively analysed 138 patients who underwent SSP surgery for the first time. Outcomes were 3-year overall survival (OS), recurrence-free survival (RFS), and short-term outcomes (PAL ≥2 days; postoperative complications [Clavien-Dindo grade ≥3] and mortality). After 1:1 PSM, we compared ILD with COPD and explored group-specific risk factors.
RESULTS: The median postoperative air leak duration was 0 days (range: 0-13). Complications occurred in 3.6%, and mortality in 2.2% of cases. Three-year OS and RFS were 85.3% and 77.7%, respectively. ILD was a risk factor for recurrence (hazard ratio [HR] 6.29, 95% confidence interval [CI] 2.29-17.33; P < .001). After PSM (25 pairs), ILD showed worse RFS (P = .001) and OS (P = .010), while short-term outcomes were comparable. In ILD, interstitial abnormalities involving >1 lobe were a risk factor for recurrence (HR 13.74, 95% CI 2.78-67.95; P = .001), and combined pulmonary fibrosis and emphysema (CPFE) was a risk factor for PAL (odds ratio [OR] 7.94, 95% CI 1.32-47.62; P = .023). In COPD, ipsilateral pneumothorax history was a risk factor for recurrence (HR 15.50, 95% CI 1.81-133.20; P = .012).
CONCLUSIONS: SSP appears safe for selected patients. Despite worse long-term outcomes in ILD, comparable short-term results support surgery when benefits are expected; caution is warranted in patients with interstitial abnormalities in >1 lobe, CPFE, or steroid therapy.
METHODS: We retrospectively analysed 138 patients who underwent SSP surgery for the first time. Outcomes were 3-year overall survival (OS), recurrence-free survival (RFS), and short-term outcomes (PAL ≥2 days; postoperative complications [Clavien-Dindo grade ≥3] and mortality). After 1:1 PSM, we compared ILD with COPD and explored group-specific risk factors.
RESULTS: The median postoperative air leak duration was 0 days (range: 0-13). Complications occurred in 3.6%, and mortality in 2.2% of cases. Three-year OS and RFS were 85.3% and 77.7%, respectively. ILD was a risk factor for recurrence (hazard ratio [HR] 6.29, 95% confidence interval [CI] 2.29-17.33; P < .001). After PSM (25 pairs), ILD showed worse RFS (P = .001) and OS (P = .010), while short-term outcomes were comparable. In ILD, interstitial abnormalities involving >1 lobe were a risk factor for recurrence (HR 13.74, 95% CI 2.78-67.95; P = .001), and combined pulmonary fibrosis and emphysema (CPFE) was a risk factor for PAL (odds ratio [OR] 7.94, 95% CI 1.32-47.62; P = .023). In COPD, ipsilateral pneumothorax history was a risk factor for recurrence (HR 15.50, 95% CI 1.81-133.20; P = .012).
CONCLUSIONS: SSP appears safe for selected patients. Despite worse long-term outcomes in ILD, comparable short-term results support surgery when benefits are expected; caution is warranted in patients with interstitial abnormalities in >1 lobe, CPFE, or steroid therapy.