Retrospective case-control study on the outcomes of early minimally invasive pleural lavage for pleural empyema in oncology patients.
empyema
pleura
thoracic surgery
Journal
Thoracic cancer
ISSN: 1759-7714
Titre abrégé: Thorac Cancer
Pays: Singapore
ID NLM: 101531441
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
revised:
28
07
2021
received:
10
06
2021
accepted:
29
07
2021
pubmed:
18
8
2021
medline:
1
2
2022
entrez:
17
8
2021
Statut:
ppublish
Résumé
Oncology patients carry a substantial risk of developing pleural empyema. Here, we report the preliminary results of our early video-assisted thoracoscopic surgery (VATS) lavage strategy in cases of empyema occurring in patients undergoing (radio-) chemotherapy. This was a retrospective case-control study comparing early VATS lavage (test group, current therapy since January 2018, n = 46) versus VATS pleurectomy (historical control; before January 2018, n = 46). Five patients in the control group and one in the test group developed recurrence of empyema within 30 days. Complications were more severe and more frequently observed in the historical control group than in the test group (30/46 vs. 12/46 CI: 5%-95%, p = < 0.05). Early VATS lavage saved operating time, allowed a shorter ICU stay (2.6 days CI: 5%-95% vs. 5.1 days CI: 5%-95%, p = ns) and an earlier hospital discharge (6.1 days CI: 5%-95% vs. 13.5 days CI: 5%-95%, p < 0.05). Moreover, radio and/or chemotherapy could be reinitiated earlier (15 ± 20.5 days CI: 5%-95% vs. 40 ± 12 days CI: 5%-95%, p < 0.05). In this retrospective cohort study, early VATS lavage was found to have a beneficial effect especially on hospital stay and enabling an earlier restart of radio- and/or chemotherapy.
Sections du résumé
BACKGROUND
Oncology patients carry a substantial risk of developing pleural empyema. Here, we report the preliminary results of our early video-assisted thoracoscopic surgery (VATS) lavage strategy in cases of empyema occurring in patients undergoing (radio-) chemotherapy.
METHODS
This was a retrospective case-control study comparing early VATS lavage (test group, current therapy since January 2018, n = 46) versus VATS pleurectomy (historical control; before January 2018, n = 46).
RESULTS
Five patients in the control group and one in the test group developed recurrence of empyema within 30 days. Complications were more severe and more frequently observed in the historical control group than in the test group (30/46 vs. 12/46 CI: 5%-95%, p = < 0.05). Early VATS lavage saved operating time, allowed a shorter ICU stay (2.6 days CI: 5%-95% vs. 5.1 days CI: 5%-95%, p = ns) and an earlier hospital discharge (6.1 days CI: 5%-95% vs. 13.5 days CI: 5%-95%, p < 0.05). Moreover, radio and/or chemotherapy could be reinitiated earlier (15 ± 20.5 days CI: 5%-95% vs. 40 ± 12 days CI: 5%-95%, p < 0.05).
CONCLUSIONS
In this retrospective cohort study, early VATS lavage was found to have a beneficial effect especially on hospital stay and enabling an earlier restart of radio- and/or chemotherapy.
Identifiants
pubmed: 34402204
doi: 10.1111/1759-7714.14109
pmc: PMC8520807
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2710-2718Informations de copyright
© 2021 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.
Références
Lancet. 1997 May 24;349(9064):1491-2
pubmed: 9167455
Chest. 1993 Mar;103(3):839-43
pubmed: 8449078
Ann Thorac Surg. 1991 Jan;51(1):39-42
pubmed: 1985571
Pneumologie. 2005 Oct;59(10):696-703
pubmed: 16222582
Chest Surg Clin N Am. 1996 Aug;6(3):461-90
pubmed: 8818416
Thorac Cancer. 2021 Oct;12(20):2710-2718
pubmed: 34402204
Surg Endosc. 2007 Feb;21(2):280-4
pubmed: 17122974
Semin Respir Crit Care Med. 2010 Dec;31(6):723-33
pubmed: 21213204
Eur J Cardiothorac Surg. 2014 Nov;46(5):907-12
pubmed: 24648424
QJM. 1996 Apr;89(4):285-9
pubmed: 8733515
Ann Thorac Surg. 2008 Dec;86(6):2008-16; discussion 2016-8
pubmed: 19022040
Langenbecks Arch Surg. 2017 Feb;402(1):15-26
pubmed: 27815709
Ann Thorac Surg. 2008 Feb;85(2):S719-28
pubmed: 18222204
Chest. 1994 Mar;105(3):832-6
pubmed: 8131548
Chest. 1995 Aug;108(2):299-301
pubmed: 7634854
Ann Thorac Surg. 2007 Jul;84(1):225-31
pubmed: 17588418
Eur Respir J. 1999 Mar;13(3):514-8
pubmed: 10232418
Cochrane Database Syst Rev. 2017 Mar 17;3:CD010651
pubmed: 28304084
Chest. 2000 Oct;118(4):1158-71
pubmed: 11035692
Ann Thorac Surg. 2007 Jun;83(6):1965-70
pubmed: 17532379
Ann Thorac Surg. 2013 Nov;96(5):1812-9
pubmed: 23987892
Can Respir J. 2008 Mar;15(2):85-9
pubmed: 18354748
J Clin Oncol. 2007 Nov 1;25(31):4993-7
pubmed: 17971599
Curr Opin Pulm Med. 2007 Jul;13(4):319-23
pubmed: 17534179
Thorax. 2003 May;58 Suppl 2:ii18-28
pubmed: 12728147
J Clin Oncol. 2009 May 20;27(15):2553-62
pubmed: 19289625
Ann Thorac Surg. 1998 Nov;66(5):1782-6
pubmed: 9875789
Eur J Cardiothorac Surg. 2015 Nov;48(5):642-53
pubmed: 26254467
Ann Thorac Surg. 2005 Jun;79(6):1851-6
pubmed: 15919270
Ann Thorac Surg. 2014 Jan;97(1):224-9
pubmed: 24119984
Ann Surg. 2009 Aug;250(2):187-96
pubmed: 19638912
Am J Respir Crit Care Med. 1999 Nov;160(5 Pt 1):1682-7
pubmed: 10556140
J Am Geriatr Soc. 2005 Jul;53(7):1203-9
pubmed: 16108939
J Thorac Cardiovasc Surg. 2007 Feb;133(2):346-51
pubmed: 17258562
Ann Thorac Surg. 2009 May;87(5):1525-30; discussion 1530-1
pubmed: 19379898
Radiology. 2007 Apr;243(1):297-8
pubmed: 17392263
Chest. 1991 May;99(5):1162-5
pubmed: 2019172
Chest Surg Clin N Am. 1996 Aug;6(3):491-9
pubmed: 8818417