Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Recurrence-Free Survival after Postoperative Hormone Therapy for Catamenial Pneumothorax

  • Ji Hoon Kim (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Won-Gi Woo (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Yong-Ho Jung (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Duk Hwan Moon (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Sungsoo Lee (Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • Received : 2024.02.28
  • Accepted : 2024.06.18
  • Published : 2024.09.05
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Abstract

Background: Catamenial pneumothorax (CP) is a rare form of spontaneous pneumothorax that is linked to endometriosis; thus, it predominantly manifests in women of reproductive age. Considerable research has explored the potential benefits of postoperative hormone therapy following various surgical interventions. This study was performed to examine the clinical implications of postoperative hormone treatment in patients with CP. Methods: The study included patients who underwent surgical intervention for CP between November 2009 and February 2023. These procedures included wedge resection, diaphragm resection, and total pleural coverage. Recurrence-free survival was analyzed using the Kaplan-Meier log-rank test to assess the impact of hormone therapy. Additionally, Cox proportional hazards analysis was employed to identify risk factors associated with postoperative CP recurrence. Results: The study included 41 patients, with a median age of 38.4 years. Among them, 27 individuals received hormone therapy, 8 of whom experienced recurrence during a median follow-up period of 1 year. Patients who received hormone therapy exhibited a lower rate of recurrence than those who did not; however, the difference was not statistically significant, likely due to the small sample size. Side effects of hormone therapy included depression (6.8%), excessive sweating (3.4%), and headache (3.4%). In the analysis of risk factors for postoperative recurrence, diaphragm resection emerged as a protective factor (hazard ratio, 0.16; 95% confidence interval, 0.03-0.77; p=0.022). Conclusion: Hormone treatment combined with surgery did not significantly impact recurrence in patients with CP. The application of diaphragm resection was the sole factor that displayed significance in preventing CP recurrence.

Keywords

Acknowledgement

The authors express their sincere gratitude for the artistic support received in relation to this work.

References

  1. Elsayed HH, Hassaballa AS, Mostafa MH, et al. Is hormonal manipulation after surgical treatment of catamenial pneumothorax effective in reducing the rate of recurrence?: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2022;278:141-7. https://doi.org/10.1016/j.ejogrb.2022.09.019
  2. Leong AC, Coonar AS, Lang-Lazdunski L. Catamenial pneumothorax: surgical repair of the diaphragm and hormone treatment. Ann R Coll Surg Engl 2006;88:547-9. https://doi.org/10.1308/003588406x130732
  3. Marshall MB, Ahmed Z, Kucharczuk JC, Kaiser LR, Shrager JB. Catamenial pneumothorax: optimal hormonal and surgical management. Eur J Cardiothorac Surg 2005;27:662-6. https://doi.org/10.1016/j.ejcts.2004.12.047
  4. Dong B, Wu CL, Sheng YL, et al. Catamenial pneumothorax with bubbling up on the diaphragmatic defects: a case report. BMC Womens Health 2021;21:167. https://doi.org/10.1186/s12905-021-01318-0
  5. Garner M, Ahmed E, Gatiss S, West D. Hormonal manipulation after surgery for catamenial pneumothorax. Interact Cardiovasc Thorac Surg 2018;26:319-22. https://doi.org/10.1093/icvts/ivx319
  6. Subotic D, Mikovic Z, Atanasijadis N, Savic M, Moskovljevic D, Subotic D. Hormonal therapy after the operation for catamenial pneumothorax: is it always necessary? J Cardiothorac Surg 2016;11:66. https://doi.org/10.1186/s13019-016-0462-7
  7. Kurihara M, Mizobuchi T, Kataoka H, et al. A total pleural covering for lymphangioleiomyomatosis prevents pneumothorax recurrence. PLoS One 2016;11:e0163637. https://doi.org/10.1371/journal.pone.0163637
  8. Demos DS, Berry MF, Backhus LM, Shrager JB. Video-assisted thoracoscopic diaphragm plication using a running suture technique is durable and effective. J Thorac Cardiovasc Surg 2017;153:1182-8. https://doi.org/10.1016/j.jtcvs.2016.11.062
  9. Toffolo Pasquini M, Auvieux R, Tchercansky A, Buero A, Chimondeguy D, Mendez J. Catamenial pneumothorax. Medicina (B Aires) 2022;82:147-50.
  10. Hung WT, Chen HM, Wu CH, Hsu WM, Lin JW, Chen JS. Recurrence rate and risk factors for recurrence after thoracoscopic surgery for primary spontaneous pneumothorax: a nationwide population-based study. J Formos Med Assoc 2021;120:1890-6. https://doi.org/10.1016/j.jfma.2020.12.011