原発性自然気胸術後再発率の評価方法とリスク分類の検討  [in Japanese] Utility of Kaplan-Meier method and risk classification for recurrence rate of primary spontaneous pneumothorax  [in Japanese]

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Abstract

原発性自然気胸の術後再発率について統一された記載基準はない.当科で手術を施行した原発性自然気胸96症例を対象としKaplan-Meier法(K法),単純法(S法)による再発率を各々算出し検討した.算出方法,患者背景からみて最も再発率が低かったのが25歳以上の群と喫煙歴のある群のK法で2.9%,最も高かったのが25歳未満の群のK法で26.6%であった. またS法では喫煙歴のない群が最も高く20.8%であり,再発率の大きな相違が判明した.再発率の算出方法に優劣はないものの標準化することが重要であり,その正確性などからK法は有用と考えられた.初回手術症例の患者背景において「25歳未満」が有意な再発因子であった.再発因子に応じて低リスク群と高リスク群に分類するとK法で術後2年時の再発率はそれぞれ0%,22.0%と有意差を認めた.将来,リスク分類に応じた治療方針立案が可能となるかもしれない.

No evaluation method has been established for primary spontaneous pneumothorax (PSP). We performed video-assisted thoracoscopic surgery (VATS) for ninety-six patients with PSP in our hospital. PSP patients were enrolled in this study from 2009. The risk factor for postoperative recurrence of PSP was the age: under 24 yo only for both uni- and multivariate analysis. Compared with the Kaplan-Meier method and a simple method which we defined as the recurrent number per objective number, the postoperative recurrence rates of PSP over 25 yo were 2.9 and 4.9%, respectively, with the Kaplan-Meier and simple methods, and that under 24 yo was 26.6%with the Kaplan-Meier method. We clarified a difference in the recurrence rate according to the statistical analysis or backgrounds, and suggest that the Kaplan-Meier method is better than the simple method regarding the accuracy. Depending on the classification for the risk factor of age, the recurrence rates of low- and high-risk groups were significant with the Kaplan-Meier method (0 vs. 22.0%, respectively, p<0.05). In conclusion, we suggest that the Kaplan-Meier method is useful for evaluation of the postoperative recurrence rate. In the near future, we may develop a strategy of individual therapy for PSP using the classification of recurrent risk.

Journal

  • The Journal of the Japanese Association for Chest Surgery

    The Journal of the Japanese Association for Chest Surgery 28(4), 427-432, 2014

    The Japanese Association for Chest Surgery

Codes

  • NII Article ID (NAID)
    130004495383
  • Text Lang
    JPN
  • ISSN
    0919-0945
  • Data Source
    J-STAGE 
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