胸腔鏡下肺瘻内充塡・縫合閉鎖法が有効であった肺Mycobacterium avium complex症による続発性自然気胸

Effective Treatment of Secondary Spontaneous Pneumothorax due to Pulmonary Mycobacterium Avium Complex by Thoracoscopic Intra-fistula Filling with Suture Closure

わが国の肺非結核性抗酸菌症の80％を占めるMycobacterium avium complex（MAC）症による続発性自然気胸の治療は，困難である場合も多い．われわれは，胸腔鏡下肺瘻内充塡および縫合・閉鎖が有効であった2例を経験したので報告する．

Secondary spontaneous pneumothorax associated with pulmonary Mycobacterium avium complex （MAC） infection is often difficult to treat. Pneumothorax associated with pulmonary MAC is characterized by a large fistula with a cavity or bronchodilation, and pleural thickening due to pleurisy. Herein, we report two cases of pneumothorax with pulmonary MAC successfully treated by minimally invasive thoracoscopic intra-fistula filling with a suture closure method. At operation, after fully filling the fistula with a polyglycolic acid （PGA） sheet and fibrin glue, the fistula was sutured with covering the PGA sheet and fibrin glue. Postoperative course was uneventful and both patient could discharged from the hospital.