Postoperative hormonal therapies reduce the recurrence of thoracic endometriosis-related pneumothorax

Abstract

OBJECTIVES Thoracic endometriosis-related pneumothorax (TERP) frequently recurs even after surgery. Meanwhile, postoperative hormonal therapies (HTx) are believed to be effective for pelvic endometriosis. Therefore, we evaluated the relationship between postoperative TERP recurrence and postoperative HTx in a retrospective observational study. METHODS We retrospectively reviewed the data of patients with TERP who underwent the first video-assisted thoracoscopic surgery between January 2011 and February 2022. RESULTS Of the 248 patients eligible for this study, 67 (27.0%) experienced postoperative TERP recurrence. Postoperative HTx were administered to 70 patients (28.2%). Dienogest was the most frequently administered drug, given to 56.7% of patients. Following univariable analysis, postoperative hormonal therapies was closely related to reduce postoperative recurrence (P = 0.003). Likewise, the multivariable analysis revealed postoperative hormonal therapies were significantly associated with the risk reduction of recurrence (hazard ratio 0.28, P < 0.001). CONCLUSIONS Postoperative HTx reduced TERP recurrence. We hypothesize that HTx may control residual endometrial tissues to avoid TERP if pleural endometrial tissues are resected as much as possible.

Catamenial pneumothorax with persistent air leak

“…Las tasas de recidiva más bajas se lograron cuando se utilizó una combinación de intervención quirúrgica que incluyera la reparación diafragmática, pleurodesis y terapia hormonal 3 . Esta última se suele indicar como complemento de la cirugía con la intención de prevenir las recidivas del neumotórax catamenial y/o relacionado con la endometriosis, mediante la supresión de la actividad del endometrio ectópico, hasta lograr formar adherencias pleurales efectivas 1 , 9 .…”