Catamenial and Noncatamenial, Endometriosis-related or Nonendometriosis-related Pneumothorax Referred for Surgery
- 15 November 2007
- journal article
- Published by American Thoracic Society in American Journal of Respiratory and Critical Care Medicine
- Vol. 176 (10), 1048-1053
- https://doi.org/10.1164/rccm.200704-587oc
Abstract
Catamenial and endometriosis-related pneumothorax are considered relatively rare entities. Their clinical characteristics and outcome are incompletely known. To evaluate the frequencies, clinical characteristics, and outcomes of catamenial and endometriosis-related pneumothoraces occurring in women with no underlying lung disease referred for surgical treatment. Clinical files of all the women of reproductive age referred to our center during a 6-year period for surgical treatment of spontaneous pneumothorax were retrospectively reviewed. Catamenial pneumothorax (CP) was defined as recurrent pneumothorax occurring between the day before and within 72 hours after the onset of menses. All histologic slides were reviewed to confirm initial diagnoses. A total of 114 women underwent video-assisted thoracic surgery; 28 women (24.6%) had CP (right-sided in all but one), and diaphragmatic abnormalities (perforations and/or nodules) were observed in 22 of them. Diaphragmatic abnormalities were seen in 21 of 86 patients with non-CP. Histologic examination found endometriosis, mainly diaphragmatic, in 18 of 28 CPs and 11 of 86 non-CPs. A 6-month antigonadotropic treatment was prescribed postoperatively to women with either CP or endometriosis-related pneumothorax. Mean follow-up was 32.7 (+/-18.5) months. Recurrence rates in CP, non-CP but endometriosis-related, and non-CP non-endometriosis-related pneumothoraces were 32, 27, and 5.3%, respectively. Our experience shows that (1) CP and/or endometriosis-related pneumothoraces account for an important percentage of spontaneous pneumothoraces referred for surgery, (2) diaphragmatic abnormalities seem to play a fundamental role in their pathogenesis, and (3) management is difficult because of the high recurrence rate.Keywords
This publication has 17 references indexed in Scilit:
- Catamenial PneumothoraxNew England Journal of Medicine, 2006
- Life-Threatening Endometriosis-Related HemopneumothoraxThe Annals of Thoracic Surgery, 2006
- Videothoracoscopic talc poudrage in primary spontaneous pneumothorax: A single-institution experience in 861 casesThe Journal of Thoracic and Cardiovascular Surgery, 2006
- Difficult management of recurrent catamenial pneumothoraxGynecological Endocrinology, 2006
- Catamenial pneumothorax: optimal hormonal and surgical managementEuropean Journal of Cardio-Thoracic Surgery, 2005
- Catamenial pneumothorax revisited: Clinical approach and systematic review of the literatureThe Journal of Thoracic and Cardiovascular Surgery, 2004
- Catamenial pneumothorax revisited: Clinical approach and systematic review of the literatureThe Journal of Thoracic and Cardiovascular Surgery, 2004
- Endometriosis-related pneumothorax: clinicopathologic observations from a newly diagnosed caseThe Journal of Thoracic and Cardiovascular Surgery, 2004
- Video-assisted thoracoscopic treatment of spontaneous pneumothorax: Technique and results of one hundred casesThe Journal of Thoracic and Cardiovascular Surgery, 1996
- Immediate and long-term results after surgical treatment of primary spontaneous pneumothorax by VATSThe Annals of Thoracic Surgery, 1996