Abstract
Matherial: 293 SP were analysed retrospectively in 232 females operated from 2004 till 2014. Only 32 (13,8%) patients had SP associated with TE. 14 (43,8%) females had the first history of SP, and 18 (56,2%) - recurrence. Each of 32 females underwent medical thoracoscopy with local anesthesia finished by chest tube drainage. 27 of 32 patients later were operated.
Results: Multiple perforation in a diaphragm were revealed in 25 (92,6%) patients during revision of a pleural cavity (in combination with endometrioisis implants in 18,8%), endometrioisis defeat of lung parenchyma was revealed in 3 (9,4%) patients, in 13 (40,6%) solderings, in 5 (15,6%) bulls less than 2 cm in the diameter. All 27 patients were operated by VATS. The biopsy of lung parenchyma with the diagnostic purpose was executed in all cases, the diaphragm resection was executed in 25 (92,6%) patients, in 6 patients resection was added by coverage of a diaphragm by a polypropylene mesh, the costal pleurectomy was executed at 26 (96,3%) patients. The long-term results are studied in all operated patients. Among 19 patients who underwent costal pleurectomy with a diaphragm resection without coverage by mesh recurrence of SP developed in 8 (42,1%) cases from 1 to 12 months after surgery. At the same time nobody of 6 patients who underwent diaphragm resection with coverage polypropylene mesh, had no recurrence SP in 15-36 months after surgery.
Conclusions: TE is the rather frequent cause of female SP. Common type of VATS for SP has high risk of recurrence in SP associated with TE. At the same time combination of costal pleurectomy and diaphragmatic resection with coverage polypropylene mesh has the optimal results.
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