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분야
ppt2.Physical Examination
3.Problem List
4.Initial Impression
5.Plan
6.Initial Lab Finding
7.Initial Radiologic Finding – 3월 17일
represents significant marker of mortality for COPD patients
causes progressive and severe dyspnea usually with pleuritic chest pain
hospitalization and intercostal chest tube required
consideration of a procedure to induce pleurodesis
recurrence rate - 40~50% without pleurodesis
recommend more aggressive approach compared with primary pneumothorax
However
little consensus exists regarding the specifics of the management approaches
American College of Chest Physicians (ACCP)
80%: chest tubes and pleurodesis in first episode to prevent recurrence
20% : defer pleurodesis until the second pneumothorax
British Thoracic Society (BTS)
reserves pleurodesis for patients with
unresolved air leak or a recurrent pneumothorax
ACCP :
Primary procedure: medical thoracoscopy or video-assisted thoracoscopic surgery
Secondary procedure: limited axillary thoracotomy with pleural abrasion
Values minimally invasive procedures
BTS :
Primary procedure: open thoracotomy
VATS reserved for patients who cannot tolerate an open procedure
high effectiveness and low mortality of the open procedure
