原発性自然気胸手術における二重被覆法の比較―合成吸収性癒着防止剤を用いて

Comparison of Dual Cover Method for Surgery with Primary Spontaneous Pneumothorax：Using Interceed

原発性自然気胸の術後再発率は3～12％1）と高く，特に若年発症の自然気胸では13～27％と報告されている2）．そのため，再発予防のために肺切除線上を含めた肺の被覆術が行われている．ポリグリコール酸（PGA）シート単独では壁側胸膜への癒着が強くなるため，その上に酸化再生セルロース（ORC）シートを重ねて貼付する二重被覆法（dual cover method）を当院でも行ってきた3）．

Objective：Lung cover method is now being used for primary spontaneous pneumothorax, because of the high rate of surgical recurrence. Dual cover method is used to avoid adhesions to parietal pleura in Japan. In this study, we compared the short-term results of dual cover method using Interceed, an adhesion-preventive material, with those of Surgicel Absorbable Hemostat MD.

Methods：Forty-six consecutive patients who underwent surgery as primary spontaneous pneumothorax at Sapporo City General Hospital from September 2023 to July 2024 were included. The patients were divided into two groups, one using Surgicel Absorbable Hemostat MD （SCHM） on a polyglycolic acid （PGA） sheet and the other using Interceed （IC） on PGA sheet, for clinical comparisons.

Results：The age of the SCHM group ranged from 12～38 years, with a mean age of 21, and IC group ranged from 16～42 years, with a mean age of 22. There was a significant difference only in operative time between the two groups, but no significant difference in blood loss, drainage time, postoperative hospital stay, or incidence of postoperative complications.

Conclusions：Short-term results showed no significant difference between Surgicel Absorbable Hemostat MD and Interceed and were safe to use. Long-term outcomes, including recurrence, need to be examined in the future.