Catamenial pneumothorax
Catamenial pneumothorax
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DOI：
10.1097/mcp.0b013e32833a9fc2
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发表时间：
2010-07-01
影响因子：
3.3
通讯作者：
Alifano, Marco
中科院分区：
文献类型：
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作者：
Alifano, Marco
综述的目的虽然知道了几十年，月经性气胸一直被认为是一个非常罕见的实体，直到最近。这种情况现在更容易识别，并且已经发表了几项研究，在病因学，流行病学和管理特征方面存在一些相关差异。在本次审查中，我将提供一个综合的可用知识的subject.Recent findingsCatamenial气胸约占三分之一的自发性气胸的妇女转介手术的情况下。在电视胸腔镜手术中，肿瘤缺损和结节是最常见的发现。病理显示子宫内膜异位症在大多数情况下。脏层胸膜内也有子宫内膜种植体，但不常见。手术探查的结果支持理论transabdominaltransammatatic通过空气来解释发病机制的月经性pneumothoracy.SummaryManagement的患者月经性气胸意味着手术，如果可能的话，通过视频辅助技术，以获得样本的病理证实子宫内膜异位症和治疗的主要致病机制的气胸。部分胸膜切除术和/或内脏胸膜植入物切除术，以及滑石粉胸膜固定术，现在经常进行。术后必须进行药物治疗以达到卵巢静息，多模式管理是这种情况下治疗成功的关键。
Purpose of reviewAlthough known for several decades, catamenial pneumothorax has been considered until recently as an extremely rare entity. The condition is now more easily recognized and several studies have been published, with somewhat relevant discrepancies with respect to etiologic, epidemiologic, and management features. In the present review, I will provide a synthesis of available knowledge on the subject.Recent findingsCatamenial pneumothorax accounts for approximately one third of cases of spontaneous pneumothoraces in women referred for surgery. At video-assisted thoracic surgery, diaphragmatic defects and nodules are the most frequent findings. Pathology shows endometriosis in most instances. Endometrial implants in visceral pleura are also found, although less frequently. Findings of surgical explorations support the theory of transabdominal-transdiaphragmatic passage of air to explain the pathogenesis of catamenial pneumothorax.SummaryManagement of patients with catamenial pneumothorax implies surgery, if possible by video-assisted technology, to obtain samples for pathologic confirmation of endometriosis and to treat the main pathogenic mechanisms of pneumothorax. Partial diaphragmatic resection and/or exeresis of visceral pleural implants, as well as talc pleurodesis, are nowadays frequently carried out. Medical therapy to achieve ovarian rest is mandatory in the postoperative period, the multimodality management being the key to treatment success in this condition.