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Conference Paper: Non-steroidal anti-inflammatory drugs increase recurrence risk following surgical pleurodesis for primary pneumothorax
Title | Non-steroidal anti-inflammatory drugs increase recurrence risk following surgical pleurodesis for primary pneumothorax |
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Authors | |
Issue Date | 2015 |
Publisher | Oxford University Press. The Journal's web site is located at https://academic.oup.com/icvts |
Citation | The 23rd European Congress on General Thoracic Surgery (ESTS 2015), Lisbon, Portugal, 31 May-3 June 2015. In Interactive Cardiovascular and Thoracic Surgery, 2015, v. 21 suppl. 1, p. S23-S24, abstract no. F-083 How to Cite? |
Abstract | Objectives: Non-steroidal anti-inflammatory drugs (NSAID) have been shown to reduce the histopathological quality of pleurodesis in animal studies, but their effect on pleurodesis in humans has not been investigated.
Methods: During January 1999 - January 2003 - when NSAIDs were still commonly used following pneumothorax surgery - 176 consecutive patients received video-assisted thoracic surgery (VATS) pleurodesis for primary pneumothorax (exclusions: secondary pneumothorax or previous pleurodesis). Recurrence defined as any new clinically or radiographically detected ipsilateral pneumothorax following surgery was documented.
Results: At the surgeon's discretion, an NSAID (Naproxen) was used for postoperative analgesia in 44 patients (25%). All major demographic and clinical factors were similar amongst the NSAID and control patients. After a median follow-up of 162.4 months (range 143-191 months), 11 patients (25%) in the NSAID group had recurrence, compared to 12 patients (9%) in the control group (HR = 2.97 [95% CI 1.14-7.79], P = 0.006). Life table analyses demonstrated no significant effect of NSAID on recurrence in the first 6 months (HR = 2.50 [95% CI 0.64-9.77], P = 0.118), but significantly higher recurrence at 9 months (HR = 3.54 [95% CI 1.01-12.48], P = 0.015) and thereafter. History of smoking is paradoxically associated with lower recurrence risk (HR = 6.17 [95% CI 2.72-13.97], P < 0.001). The effect of NSAID on recurrence is more pronounced in non-smokers (HR = 3.46 [95% CI 1.21-9.89], P = 0.003), but not significant in smokers (HR = 1.53 [95% CI 0.11-21.24], P = 0.725). The mean total dose of NSAID use showed a trend of association with recurrence (Recurrence: 2113 mg; No recurrence: 1803 mg; P = 0.053). Recurrence was not correlated with any other demographic or clinical variables. Use of NSAID failed to reduce pain scores on postoperative day 1.
Conclusions: Use of NSAIDs after surgical pleurodesis for primary pneumothorax increases recurrence risk, while being ineffective in pain control. Routine NSAIDs use following surgical pleurodesis should be avoided, particularly for non-smokers.
Disclosure: No significant relationships. |
Description | Session 8 - Mixed Thoracic 1: no. F-083 |
Persistent Identifier | http://hdl.handle.net/10722/215343 |
ISSN | 2023 Impact Factor: 1.6 2020 SCImago Journal Rankings: 0.546 |
DC Field | Value | Language |
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dc.contributor.author | Yu, P | - |
dc.contributor.author | Lim, HCC | - |
dc.contributor.author | Yam, NLH | - |
dc.contributor.author | Sihoe, A | - |
dc.date.accessioned | 2015-08-21T13:22:42Z | - |
dc.date.available | 2015-08-21T13:22:42Z | - |
dc.date.issued | 2015 | - |
dc.identifier.citation | The 23rd European Congress on General Thoracic Surgery (ESTS 2015), Lisbon, Portugal, 31 May-3 June 2015. In Interactive Cardiovascular and Thoracic Surgery, 2015, v. 21 suppl. 1, p. S23-S24, abstract no. F-083 | - |
dc.identifier.issn | 1569-9293 | - |
dc.identifier.uri | http://hdl.handle.net/10722/215343 | - |
dc.description | Session 8 - Mixed Thoracic 1: no. F-083 | - |
dc.description.abstract | Objectives: Non-steroidal anti-inflammatory drugs (NSAID) have been shown to reduce the histopathological quality of pleurodesis in animal studies, but their effect on pleurodesis in humans has not been investigated. Methods: During January 1999 - January 2003 - when NSAIDs were still commonly used following pneumothorax surgery - 176 consecutive patients received video-assisted thoracic surgery (VATS) pleurodesis for primary pneumothorax (exclusions: secondary pneumothorax or previous pleurodesis). Recurrence defined as any new clinically or radiographically detected ipsilateral pneumothorax following surgery was documented. Results: At the surgeon's discretion, an NSAID (Naproxen) was used for postoperative analgesia in 44 patients (25%). All major demographic and clinical factors were similar amongst the NSAID and control patients. After a median follow-up of 162.4 months (range 143-191 months), 11 patients (25%) in the NSAID group had recurrence, compared to 12 patients (9%) in the control group (HR = 2.97 [95% CI 1.14-7.79], P = 0.006). Life table analyses demonstrated no significant effect of NSAID on recurrence in the first 6 months (HR = 2.50 [95% CI 0.64-9.77], P = 0.118), but significantly higher recurrence at 9 months (HR = 3.54 [95% CI 1.01-12.48], P = 0.015) and thereafter. History of smoking is paradoxically associated with lower recurrence risk (HR = 6.17 [95% CI 2.72-13.97], P < 0.001). The effect of NSAID on recurrence is more pronounced in non-smokers (HR = 3.46 [95% CI 1.21-9.89], P = 0.003), but not significant in smokers (HR = 1.53 [95% CI 0.11-21.24], P = 0.725). The mean total dose of NSAID use showed a trend of association with recurrence (Recurrence: 2113 mg; No recurrence: 1803 mg; P = 0.053). Recurrence was not correlated with any other demographic or clinical variables. Use of NSAID failed to reduce pain scores on postoperative day 1. Conclusions: Use of NSAIDs after surgical pleurodesis for primary pneumothorax increases recurrence risk, while being ineffective in pain control. Routine NSAIDs use following surgical pleurodesis should be avoided, particularly for non-smokers. Disclosure: No significant relationships. | - |
dc.language | eng | - |
dc.publisher | Oxford University Press. The Journal's web site is located at https://academic.oup.com/icvts | - |
dc.relation.ispartof | Interactive Cardiovascular and Thoracic Surgery | - |
dc.title | Non-steroidal anti-inflammatory drugs increase recurrence risk following surgical pleurodesis for primary pneumothorax | - |
dc.type | Conference_Paper | - |
dc.identifier.email | Yu, P: yusyp@hku.hk | - |
dc.identifier.email | Sihoe, A: adls1@hku.hk | - |
dc.identifier.authority | Yu, P=rp01763 | - |
dc.identifier.authority | Sihoe, A=rp01889 | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1093/icvts/ivv204.83 | - |
dc.identifier.hkuros | 248840 | - |
dc.identifier.volume | 21 | - |
dc.identifier.issue | suppl. 1 | - |
dc.identifier.spage | S23, abstract no. F-083 | - |
dc.identifier.epage | S24 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 1569-9285 | - |