Comparison of surgical outcomes after pneumonectomy and pulmonary function-preserving surgery for non-small cell lung cancer

Higuchi, Mitsunori; Takagi, Hironori; Ozaki, Yuki; Inoue, Takuya; Watanabe, Yuzuru; Yamaura, Takumi; Fukuhara, Mitsuro; Muto, Satoshi; Okabe, Naoyuki; Matsumura, Yuki; Hasegawa, T.; Osugi, Jun; Hoshino, Mika; Shio, Yutaka; Suzuki, Hiroyuki

doi:10.5387/fms.2017-10

Cited by 5 publications

(5 citation statements)

References 18 publications

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“…For central lung cancer, which often involves the hilum, pneumonectomy is one of the means of treatment that has the opportunity to cure the disease, which can substantially prolong the survival time of patients [ 1 , 11 ]. However, due to the high trauma of the operation, pneumonectomy is often (20–60%) followed by postoperative complications, such as low-volume circulatory disorder, pulmonary edema, pneumonia, and acute respiratory failure [ 2 , 3 , 12 ]. Eric Yu Wei Lo et al concluded that compared with clamp-release drainage, balanced chest drainage results in a lower incidence of postpneumonectomy pulmonary edema and death [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…There is an urgent need for a simple and effective drainage method to reduce the incidence of postoperative complications after pneumonectomy. In recent years, as thoracoscopic surgery technology and the concept of ERAS have advanced, approaching pneumonectomy by minimally invasive approaches has not negatively impacted perioperative outcomes, and the incidence of complications such as empyema, mediastinal shift and major bleeding requiring reopening has decreased [ 12 ]. There is no consensus on the management of pneumonectomy postoperative drainage.…”

Section: Discussionmentioning

confidence: 99%

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Safety of one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after uniportal video-assisted thoracoscopic surgery pneumonectomy

Kong,

Zhang,

Jia

et al. 2024

J Cardiothorac Surg

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Objectives Uniportal video-assisted thoracoscopic surgery pneumonectomy (U-VATS-P) is feasible and safe from a perioperative standpoint. How to choose the proper chest tube and drainage method is important in enhanced recovery after surgery (ERAS) protocols. In this study, we aimed to assess the safety of one 8.5-Fr (1Fr = 0.333 mm) pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P. Methods We retrospectively reviewed a single surgeon’s experience with U-VATS-P for lung cancer from May 2016 to September 2022. Patients were managed with one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P. The clinical characteristics and perioperative outcomes of the patients were retrospectively analyzed. Results In total, 77 patients had one 8.5-Fr pigtail catheter placed for postoperative continuous open gravity drainage after U-VATS-P for lung cancer. The mean age was 60.9$$\pm$$7.39 (40–76) years; The mean FEV1 was 2.1$$\pm$$0.6 (l/s), and the mean FEV1% was 71.2$$\pm$$22.7. The median operative time was 191.38$$\pm$$59.32 min; the mean operative hemorrhage was 109.46$$\pm$$96.56 ml; the mean duration of postoperative chest tube drainage was 6.80$$\pm$$2.33 days; the mean drainage volumes in the first three days after operation were 186.31$$\pm$$50.97, 321.97$$\pm$$52.03, and 216.44$$\pm$$35.67 ml, respectively; and the mean postoperative hospital stay was 7.90$$\pm$$2.58 days. No patient experienced complications resulting from chest tube malfunction. Ten patients experienced minor complications. One patient with nonlife-threatening empyema and bronchopleural fistula required short rehospitalization for anti-inflammatory therapy and reintubation. Three patients with chylothorax were treated with intravenous nutrition. Four patients had atrial fibrillation that was controlled by antiarrhythmic therapy. Two patients had more thoracic hemorrhagic exudation after the operation, which was found in time and was cured effectively, so they were discharged from the hospital uneventfully after early hemostatic therapy and nutritional support. Conclusions All patients in this study received early postoperative rehabilitation, and the rate of relevant complications was low. We therefore recommend a single 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage as an effective, safe and reliable drainage method for the management of U-VATS-P.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Safety of one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after uniportal video-assisted thoracoscopic surgery pneumonectomy

Kong,

Zhang,

Jia

et al. 2024

J Cardiothorac Surg

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show abstract

“…For central lung cancer often involving the hilum, pneumonectomy is one of the means for the treatment that has the opportunity to cure the disease, which can effectively prolong the survival time of patients [1] [11]. However, due to the greater trauma of the operation, pneumonectomy often followed by postoperative complications with an incidence of 20-60% such as low volume circulatory disorder, pulmonary edema, pneumonia, and acute respiratory failure [2][3] [12]. In recent years, with the development of thoracoscopic surgery technology and the concept of ERAS, approaching pneumonectomy by minimally invasive approaches does not negatively impact perioperative outcomes and the incidence of complications such as empyema, mediastinal shift and major bleeding requiring reopening is decreasing [12].…”

Section: Discussionmentioning

confidence: 99%

“…However, due to the greater trauma of the operation, pneumonectomy often followed by postoperative complications with an incidence of 20-60% such as low volume circulatory disorder, pulmonary edema, pneumonia, and acute respiratory failure [2][3] [12]. In recent years, with the development of thoracoscopic surgery technology and the concept of ERAS, approaching pneumonectomy by minimally invasive approaches does not negatively impact perioperative outcomes and the incidence of complications such as empyema, mediastinal shift and major bleeding requiring reopening is decreasing [12]. At present, there is no consensus on the management of pneumonectomy postoperative drainage.…”

Section: Discussionmentioning

confidence: 99%

Safety of one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after uniportal video-assisted thoracoscopic surgery pneumonectomy

Kong

Zhang

et al. 2023

Preprint

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OBJECTIVES Uniportal video-assisted thoracoscopic surgery pneumonectomy (U-VATS-P) is feasible and safe from a perioperative standpoint in clinical practice. How to choose proper chest tube and drainage method is an important step in enhanced recovery after surgery (ERAS) protocols. In this study, we aimed to assess the safety of one 8.5-Fr (1Fr = 0.333mm) pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P. METHODS We retrospectively reviewed a single surgeon’s experience of U-VATS-P for lung cancer from May 2016 to September 2022. Patients were managed with one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P. The clinical characteristics and perioperative outcomes of the patients were retrospectively analyzed. RESULTS In total, 77 patients underwent the placement of one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P for lung cancer. The mean age was 60.9$\pm$7.39 (40–76) years old; the median operative time was 191.38$\pm$59.32min; the mean operative hemorrhage was 109.46$\pm$96.56ml; the mean duration of postoperative chest tube drainage was 6.80$\pm$2.33 days; the mean drainage volume in the first three days after operation was 186.31$\pm$50.97, 321.97$\pm$52.03, 216.44$\pm$35.67ml respectively; the mean postoperative hospital stay was 7.90$\pm$2.58 days. No patient experienced complications resulting from chest tube malfunction. Ten patients experienced minor complications. One patient with non-life-threatening empyema and bronchopleural fistula required short rehospitalization for anti-inflammatory therapy and re-intubation. Three patients with chylothorax were treated with intravenous nutrition. Four patients had atrial fibrillation that were controlled by antiarrhythmic therapy. Two patients had more thoracic hemorrhagic exudation after operation that could be found in time and were cured effectively and discharged from the hospital uneventfully after early hemostatic therapy and nutritional support. CONCLUSIONS Insertion of one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P is a safe and effective procedure in the treatment of lung cancer without a major increase in morbidity or mortality and should be popularized.

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“…Apesar de a cirurgia oncológica ser o procedimento que gera mais danos na função pulmonar quando comparada aos outros 33 , sabe-se que a radioterapia também tem efeitos deletérios sobre a funcionalidade respiratória, estando relacionada principalmente à dosagem e local de incidência 26 . Essas repercussões se dão pelo desenvolvimento de pneumonite actínica e fibrose pulmonar, que se manifestam de modo agudo e tardio, respectivamente 10 .…”

Section: Discussionunclassified

Avaliação da função pulmonar de pacientes oncológicos submetidos a quimioterapia

Magno¹,

Cruz²,

Marques³

et al. 2021

ASSOBRAFIR Ciênc

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Comparison of surgical outcomes after pneumonectomy and pulmonary function-preserving surgery for non-small cell lung cancer

Abstract: The short-term results were better in Group PS than PN. However, the long-term results in both groups were similar. Other causes of death influenced OS in both groups; this result might have been affected by the surgical procedures.

Cited by 5 publications

References 18 publications

Safety of one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after uniportal video-assisted thoracoscopic surgery pneumonectomy

Safety of one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after uniportal video-assisted thoracoscopic surgery pneumonectomy

Safety of one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after uniportal video-assisted thoracoscopic surgery pneumonectomy

Avaliação da função pulmonar de pacientes oncológicos submetidos a quimioterapia

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