Author of

• 12495

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  P3.07 - Poster Session 3 - Surgery (ID 193)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12508

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    P3.07-013 - Chylothorax Complicating Video-assisted Thoracoscopic Pulmonary Resection in Non-small Cell Lung Cancer (ID 1392)

    09:30 - 09:30  |  Author(s): Y. Sun
    • Abstract

    Background
    Chylothorax complicating pulmonary resection (CCPR) is an infrequent but well-known complication in lung cancer surgery. Previous published studies on this topic were limited and standard thoracotomy for pulmonary resection (STPR) was the surgical approach. Video-assisted thoracoscopic pulmonary resection (VATPR) has become prevalent in the lung cancer surgery nowadays. The purpose of this study is to analyze the clinical data of CCPR after VATPR and evaluate their outcome after treatment.

    Methods
    Between January 2010 and May 2013, we retrospectively reviewed 728 primary non-small cell lung cancer patients who undergone VATPR and mediastinal lymph node dissection (MLND) in our institute. CCPR were noted in 18 patients (2.47%) who constitute the subjects of our study. We initially treated these patients conservatively with oral intake cessation and parenteral nutrition. If conservative treatment failed, reoperation with video-assisted thoracic surgery (VATS) for thoracic duct ligation would be performed. Daily pleural drainage amount, timing of surgical intervention, and treatment responses were recorded and investigated. The data collected were compared to other studies in which STPR was the main operative method.

    Results
    Among the 18 CCPR cases, all of them were adenocarcinoma on the right side of lung. Thirteen of patients received conservative treatment and 5 patients received reoperation for CCPR. All of them were successfully treated with cessation of CCPR without mortality. The average pleural drainage amounts per day in conservative treatment group and reoperation group were 206 ml and 433 ml. The presented study suggests that CCPR with pleural drainage amount less than 400 ml in the first postoperative day will subsided after conservative treatment. CCPR with pleural drainage amount more than 400 ml in the first or second postoperative day can also resolve if drainage amount below 400 ml was seen in the postoperative day 4 and thereafter. Reoperations would be undertaken for CCPR in cases with increasing amount of pleural drainage in the postoperative 4 after conservative treatment.

    Conclusion
    chylothorax, video-assisted thoracoscopic pulmonary resectionVATPR did not incur more CCPR than did STPR in NSCLC surgery. The average pleural drainage amount of CCPR in reoperation cases was less in our study than that in other studies. The timing of surgical intervention for CCPR following VATPR can be earlier if pleural drainage didn’t show trend of decrease after conservative treatment. Figure 1