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A deep azygoesophageal recess may increase the risk of secondary spontaneous pneumothorax

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Abstract

Purpose

The azygoesophageal recess (AER) is known as a possible cause of bulla formation in patients with spontaneous pneumothorax. However, there has been little focus on the depth of the AER. We evaluated the relationship between the depth of the AER and pneumothorax development.

Methods

We conducted a retrospective study of 80 spontaneous pneumothorax patients who underwent surgery at our institution. We evaluated the depth of the AER on preoperative computed tomography scans.

Results

Ruptured bullae at the AER were found in 12 patients (52.2%) with secondary spontaneous pneumothorax (SSP) and 8 patients (14.0%) with primary spontaneous pneumothorax (PSP) (p < 0.001). In patients with ruptured bullae at the AER, 10 SSP patients (83.3%) had a deep AER while only 2 PSP patients (25%) had a deep AER (p = 0.015).

Conclusions

A deep AER was more frequently associated with SSP than with PSP. A deep AER may contributes to bulla formation and rupture in SSP patients.

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Authors and Affiliations

  1. Department of Thoracic Surgery, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Tsuyoshi Takahashi, Mitsuaki Kawashima, Hideki Kuwano, Kazuhiro Nagayama, Jyunichi Nitadori, Masaki Anraku, Masaaki Sato, Tomohiro Murakawa & Jun Nakajima

  2. Department of Thoracic Surgery, Kansai Medical University, 2-3-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan

    Tomohiro Murakawa

Authors
  1. Tsuyoshi Takahashi
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  2. Mitsuaki Kawashima
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  3. Hideki Kuwano
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  4. Kazuhiro Nagayama
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  5. Jyunichi Nitadori
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  6. Masaki Anraku
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  7. Masaaki Sato
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  8. Tomohiro Murakawa
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  9. Jun Nakajima
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Correspondence to Tsuyoshi Takahashi.

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All authors have no conflicts of interest to disclose.

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Takahashi, T., Kawashima, M., Kuwano, H. et al. A deep azygoesophageal recess may increase the risk of secondary spontaneous pneumothorax. Surg Today 47, 1147–1152 (2017). https://doi.org/10.1007/s00595-017-1482-1

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  • DOI: https://doi.org/10.1007/s00595-017-1482-1

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