This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Paola Ciriaco Giampiero Negri Lidia Libretti Angelo Carretta Giulio Melloni Monica Casiraghi Piero Zannini Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ciriaco, P. Articles by Zannini, P. Search for Related Content PubMed PubMed Citation Articles by Ciriaco, P. Articles by Zannini, P.

Surgical treatment of catamenial pneumothorax: a single centre experience

Department of Thoracic Surgery, Scientific Institute and University Vita-Salute H San Raffaele, Milan, Italy

*Corresponding author. Department of Thoracic Surgery, Hospital San Raffaele, Via Olgettina 60, 20132 Milan, Italy. Tel.: +39-02-26437138; fax: +39-02-26437147.

E-mail address: ciriaco.paola{at}hsr.it (P. Ciriaco).

We retrospectively reviewed our experience with catamenial pneumothorax (CP) in terms of treatment and follow-up. From 1993 to 2008, ten women presented at our department with CP. CP was right-sided in all patients: seven presented diaphragmatic defects including one endometriosis, five had apical bulla or blebs that in three patients were the only pathological findings. Surgical approach was thoracoscopic with a muscle-sparing thoracotomy when diaphragmatic defects where present. All patients underwent apical resection and apical pleurectomy associated in seven cases with diaphragmatic plication and chemical pleurodesis. After surgery nine patients underwent hormonal treatment: three were put on estrogen–progesterone complex treatment and six received gonadotropin-releasing hormone agonist (GnRH agonist). Recurrence rate was 40% and it was significantly correlated with estrogen–progesterone treatment (P<0.005). The mean follow-up was 52±32 months (range 14–168). At the present time, no recurrence has occurred in all women. Occurrence of CP is often underestimated. At the time of surgery the diaphragm should be carefully inspected for defects and/or endometriosis. Standard pleurodesis may not suffice and we suggest apical resection and apical pleurectomy associated with a diaphragmatic procedure when indicated. Hormonal treatment with GnRH agonist seems to improve the outcome.

Key Words: Catamenial pneumothorax; Thoracic endometriosis; Hormonal therapy