JTCS Click here to go to SJM website.
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Yeung-Leung Cheng
Ching Tzao
Right arrow Permission Requests
Google Scholar
Right arrow Articles by Cheng, Y.-L.
Right arrow Articles by Chang, H.
PubMed
Right arrow Articles by Cheng, Y.-L.
Right arrow Articles by Chang, H.
Related Collections
Right arrow Lung - other

J Thorac Cardiovasc Surg 2009;138:192-195
© 2009 The American Association for Thoracic Surgery

Perioperative Management

The impact of smoking in primary spontaneous pneumothorax

Yeung-Leung Cheng, MD, PhDa,*, Tsai-Wang Huang, MDa, Chih-Kung Lin, MDb, Shih-Chun Lee, MDa, Ching Tzao, MD, PhDa, Jen-Chih Chen, MDa, Hung Chang, MD, PhDa

a Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
b Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC

Received for publication March 17, 2008; revisions received October 12, 2008; accepted for publication December 24, 2008.

* Address for reprints: Yeung-Leung Cheng, MD, PhD, Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, 325, Section 2, Cheng-Kung Road, Taipei 114, Taiwan, ROC. (Email: ndmc0928{at}yahoo.com.tw).

Background: The crucial role of cigarette smoking in the development of pneumothorax is unclear because nonsmokers can also develop primary spontaneous pneumothorax. The purpose of this study was to clarify the pathophysiologic effects of cigarette smoking and its clinical correlations in primary spontaneous pneumothorax.

Methods: Included were 115 specimens of lung tissue from patients with primary spontaneous pneumothorax who underwent video-assisted thoracoscopic surgery from January 2001 to December 2002. We reviewed the clinical features of 56 smokers and 59 nonsmokers with an average follow-up of 67 months. The pathologic findings of resected lung specimens were analyzed retrospectively.

Results: There were no statistical differences in sex, age, body height, body weight, body mass index, or the presence of blebs/bullae on computed tomography scans of the lung or under thoracoscopy between the 2 groups. In the smoking group, patients had more extensive respiratory bronchiolitis (P < .001), a high prevalence of tobacco pigmentation (P < .001), and a higher recurrence rate without or after surgery than the nonsmoking group (57% vs 22%, P = .001 and 8.9% vs 1.7%, P = .02, respectively). Patients with extensive respiratory bronchiolitis had significantly higher nonoperative and postoperative recurrences than patients with nonextensive respiratory bronchiolitis (P = .004 and P < .001, respectively).

Conclusion: Cigarette smoking is associated with the pathophysiologic consequences of extensive respiratory bronchiolitis, which had a significant impact on the recurrence rates of primary spontaneous pneumothorax.

Abbreviations and Acronyms HRCT = high-resolution computed tomography; VATS = video-assisted thoracoscopic surgery






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2009 by The American Association for Thoracic Surgery.