Author of

• 20195

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  P3.16 - Surgery (ID 732)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Surgery
  • Presentations: 2
  • Moderators:
  • Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 24232

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    P3.16-009 - Reoperation for Hemostasis within 24 Hours Can Get a Better Short-Term Outcome When Indicated after Lung Cancer Surgery (ID 8000)

    09:30 - 09:30  |  Presenting Author(s): Qiang Li
    • Abstract
    • Slides

    Background:
    Postoperative hemorrhage after lung cancer surgery is a potentially fatal complication. This study aimed to investigate the indications and timing of reoperation for postoperative hemorrhage after lung cancer surgery.
    
    Method:
    We identified all patients who underwent lung resection and mediastinal lymph node dissection for lung cancer between October 2001 and September 2015 at Sichuan Cancer Hospital, identifying 57 who had undergone reoperation for hemostasis. The records of these 57 patients were reviewed and analyzed.
    
    Result:
    The most common postoperative hemorrhage site was the separation surface of the original pleural adhesions (29.8%). The median time interval between the initial operation and reoperation was 12 hours (range, 2-432 hours), and most patients (77.2%) underwent reoperation within 24 hours. The overall morbidity and mortality rates of reoperation were 50.9% and 5.3%, respectively. The morbidity rates of early reoperation group (≤ 24 hours) and late reoperation group were 43.2% and 77.0%, respectively, which were significantly different (P=0.033). The mortality rates of early reoperation group and late reoperation group were 0 and 23.1%, respectively, which were also significantly different (P=0.010).

    Table 1 Origin of postoperative bleeding for reoperation

    Origin of bleeding	Number of patients (n=57)	Percentage
    Pulmonary resection surface	1	1.8
    Pulmonary artery trunk	1	1.8
    Pulmonary artery branch	2	3.5
    Chest wall invasion resection surface	4	7.0
    Intercostal blood vessel	4	7.0
    Bronchial artery	6	10.5
    Hemothorax-unknown origin	11	19.3
    Lymph node dissection surface	11	19.3
    Pleural adhesion separation surface	17	29.8

    Figure 1
    
    
    
    Conclusion:
    Once indications of reoperation for postoperative hemorrhage after lung cancer surgery are identified, reoperation within 24 hours after the initial operation can get a better short-term outcome.
    
    

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  • 24260

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    P3.16-037 - Superior Vena Cava Replacement Combined with Veno-Venous Shunt for Lung Cancer and Thymoma: Case Series (ID 8036)

    09:30 - 09:30  |  Presenting Author(s): Qiang Li
    • Abstract
    • Slides

    Background:
    Superior vena cava (SVC) replacement is infrequently performed and technically challenging in low-volume centers. Veno-venous shunt (VVS) technique is used to reduce SVC pressure during SVC replacement and has not been well reported. This study aims to add experience on this subject and evaluate the surgical outcomes of patients who undergo SVC replacement combined with VVS in our center.
    
    Method:
    A retrospective analysis of six patients who received SVC replacement combined with VVS from September 2011 to February 2017 was performed. Clinical characteristics, pathological features, operative characteristics, postoperative outcomes and survival of six patients were reviewed.
    
    Result:
    There were four males and two females with a median age of 44 years (range, 35-69 years). There were three lung cancer patients and three thymoma patients at a stage from IIIA to IVA. Five patients underwent induction therapy. Complete resection was performed on five patients. One case underwent internal VVS, and the other five cases underwent external VVS. Prosthesis grafts were employed in five cases and autologous pericardium in one case. Three cases underwent single-vein reconstruction, and the other three cases underwent double-vein reconstruction. The median SVC clamping time was 75 minutes. There were no postoperative deaths and major complications. All follow-up patients were alive, and no thrombosis was found in all the grafts.

    Table 1 Clinical and pathological characteristics of six patients

    Case	Year	Age(years),sex	Tumor	Status	Treatment	Response after induction	Histology	Stage
    1	2011	35,male	Thymoma	Primary	CRT+S+CT+S	PR	B2 thymoma	IVA
    2	2012	46,male	Lung cancer	Primary	CT+S+CT	PR	Adenocarcinoma	pT4N2M0, IIIB
    3	2015	37,female	Thymoma	Primary	CRT+S+CT	PR	B2 thymoma	III
    4	2015	42,female	Thymoma	Recurrence	S+RCT	-	B1 thymoma	III
    5	2016	54,male	Lung cancer	Primary	CT+S+CRT	SD	Squamous cell carcinoma	pT4N2M0, IIIB
    6	2017	69,male	Lung cancer	Recurrence	CRT+S+CT	SD	Squamous cell carcinoma	pT4N0M0, IIIA

    CRT, chemoradiotherapy; CT, chemotherapy; PR, partial response; RT, radiotherapy; S, surgery; SD, stable disease
    
    Conclusion:
    SVC replacement combined with VVS is technically feasible and safe. Although VVS technique is not a must, it may make SVC replacement safer in inexperienced centers. Surgery-based multidisciplinary treatment for selected patients with type T4 lung cancer and SVC involvement or thymoma and SVC involvement may achieve a favorable long-term outcome.
    
    

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