Extragenital endometriosis as a cause of catamenial pneumothorax in women: own experience

Abstract

Introduction. Catamenial pneumothorax is one of the most difficult to diagnose types of spontaneous pneumothorax in women. The cause of the latter is ectragenital localization of endometriosis. To date, there is no clear pathogenetically determined treatment and treatment algorithm for the management of this category of patients. Objective: to analyze and structure our own experience in the treatment of catamenial pneumothorax. Materials and methods. For the period 2011–2020 in the Thoracoabdominal Department of the SI "Zaytcev Institute of General and Emergency Surgery of the National Academy of Medical Sciences of Ukraine" 7 women with catamenial pneumothorax were on inpatient treatment. Results. After additional examination, all patients underwent draining of the pleural cavity with Bulau as the first stage after the diagnosis was established. At the second stage, all patients underwent minimally invasive surgical interventions – videothoracoscopic resection of the endometriosis-affected areas of the costal parietal pleura and diaphragm, mechanical pleurarasion and pleurodesis, using fibrin-collagen plates in the areas of diaphragm defects. There were no postoperative complications or deaths. Conclusion. In the treatment of extragenital endometriosis complicated by catamenial pneumothorax, not only thoracic surgeons, but also obstetrician-gynecologists should take part in order to create multidisciplinary commissions aimed primarily at determining the pathogenetically determined treatment tactics. Key words: extragenital endometriosis, catamenial pneumothorax, videothoracoscopy, surgical treatment.