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[Apical tenting with polyglycolic acid sheet for primary pneumothorax]
1Department of Thoracic Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|April 16, 2011
Summary
Apical tenting using a polyglycolic acid sheet after surgery for primary spontaneous pneumothorax reduces recurrent pneumothorax. However, this method does not prevent the recurrence of apical bullae.
Area of Science:
- Thoracic Surgery
- Pulmonary Medicine
- Biomaterials in Surgery
Context:
- Primary spontaneous pneumothorax (PSP) often recurs after apical bullectomy due to the "dead space" problem.
- Recurrent pneumothorax and bullous formation remain significant challenges post-surgery.
Purpose:
- To evaluate the efficacy of apical tenting with a large polyglycolic acid (PGA) sheet in attenuating lung over-expansion and reducing recurrence after apical bullectomy for PSP.
- To assess the correlation between lung shrinkage and the recurrence of bullae and pneumothorax.
Summary:
- Forty-three patients with PSP underwent apical tenting with a 15x15 cm PGA sheet.
- Lung shrinkage was measured postoperatively; bullous formation recurred in 6 patients, and pneumothorax recurred in 3.
- Apical tenting correlated with reduced pneumothorax recurrence but not recurrent bullous formation.
Impact:
- Apical tenting with PGA sheets is a viable technique to decrease the rate of pneumothorax recurrence following apical bullectomy.
- The technique does not inhibit the underlying process of recurrent bullous formation, suggesting further research is needed.
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