Comparison of early recurrence in young-onset primary spontaneous pneumothorax following surgery using different covering methods.

OBJECTIVES: The treatment of primary spontaneous pneumothorax not only involves bulla resection via video-assisted thoracic surgery but also covers the lesion. Ideal treatment should minimize adhesions and reduce the recurrence rate. This study aimed to explore different covering methods and compare the frequency of early recurrence for each covering method. METHODS: We included 370 subjects with primary spontaneous pneumothorax < 25 years who were treated with video-assisted thoracic surgery from August 2012 to December 2022. Subjects were divided into three groups depending on how the treated lesions were covered. The P group included 162 subjects treated between April 2012 and June 2017 whose lesions were covered using polyglycolic acid sheets on the staple line of the bulla resection lesion. The O group included 93 subjects treated between July 2017 and July 2019 whose lesions were covered with oxidized regenerated cellulose over a polyglycolic acid sheet. The N group included 115 subjects treated between August 2019 and December 2022 whose lesions were covered with oxidized regenerated cellulose over a polyglycolic acid nano sheet. RESULTS: Recurrence rates were 3.7%, 8.6%, and 6.0% in the P, O, and N groups, respectively; however, the differences were not statistically significant. The adhesions were milder in the N group than in the P and O groups. CONCLUSIONS: Although both covering methods were effective in preventing recurrence, further studies involving further treatment modifications and longer-term follow-ups are required.

[Inflammatory Polyp due to Peanut Aspiration, Needed to Differentiate from Malignant Tumor: Report of a Case].

The patient was in his 70s. He was addmitted to our hospital because of obstructive pneumonia for 3 months. Chest computed tomography( CT) showed a nodule at the base of the right B8, obstructing the basal branch, with consolidation of the peripheral lung. Bronchoscopy revealed the right basal trunk obstruction by a tumorous lesion. FDG-PET showed heterogeneous FDG uptake at the right hilum and the lower lobe suggesting malignancy, and a thoracoscopic right lower lobectomy was performed. Pathology showed a granulation-like nodule and a brown oval foreign body incarcerated in the peripheral bronchus, which was later revealed to be a peanut, and no obvious malignant findings were observed.

[Invasive Mucinous Adenocarcinoma that Invades the Wall of a Cystic Lesion:Report of a Case].

Invasive mucinous adenocarcinoma (IMA) is a rare and special type of lung adenocarcinoma. We report a case of IMA presenting as a cystic lesion in the S10 of the right lung, diagnosed by surgical biopsy and treated with right lower lobectomy. The patient was a 60-year-old man who was found to have a 10-mm-sized frosted ground-glass opacity with a 10-mm-sized air space in the S10 of the right lung while undergoing follow-up after renal cancer surgery in 2018. The air space gradually enlarged and, in 2022, began to show a 40-mm-sized cyst, with partial wall thickening and nodularity on the caudal side. A thoracoscopic partial pneumonectomy was performed to confirm the diagnosis of IMA, and a thoracoscopic radical resection of the right remaining lower lobe was performed. It is important to recognize that adenocarcinoma may occur in patients with thin-wall cavity, as in this case. Additionally, it is necessary to determine the treatment strategy based on the assumption that the tumor may extend to the entire cavity wall, even if it is thin-walled.