Oncotarget

Clinical Research Papers:

Postoperative empyema following lung cancer surgery

Noriyuki Matsutani _, Katsuo Yoshiya, Masayuki Chida, Hirozo Sakaguchi, Takuma Kikkawa, Hiroki Fukuda, Nobumasa Takahashi, Noriyoshi Sawabata, Hirotoshi Horio, Nobuhiko Seki and Masafumi Kawamura

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Oncotarget. 2018; 9:29810-29819. https://doi.org/10.18632/oncotarget.25629

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Abstract

Noriyuki Matsutani1, Katsuo Yoshiya2, Masayuki Chida3, Hirozo Sakaguchi4, Takuma Kikkawa5, Hiroki Fukuda6, Nobumasa Takahashi7, Noriyoshi Sawabata8, Hirotoshi Horio9, Nobuhiko Seki1 and Masafumi Kawamura1

1Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan

2Department of Thoracic Surgery, Niigata Cancer Center Hospital, Niigata, Japan

3Department of General Thoracic Surgery, Dokkyo Medical University, Tochigi, Japan

4Department of General Thoracic Surgery, Saitama International Medical Center, Saitama Medical University, Saitama, Japan

5Department of Surgery I, Tokyo Women's Medical University, Tokyo, Japan

6Department of General Thoracic Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan

7Department of Thoracic Surgery, Saitama Cardiovascular and Respiratory Center, Saitama, Japan

8Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Nara, Japan

9Department of General Thoracic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan

Correspondence to:

Noriyuki Matsutani, email: matsutani1970@yahoo.co.jp

Keywords: empyema; lung cancer; postoperative infection; surgery; mortality

Abbreviations: VATS: video-assisted thoracic surgery

Received: February 27, 2018     Accepted: June 04, 2018     Published: July 03, 2018

ABSTRACT

Postoperative empyema following lung cancer surgery is a serious complication. Occurrence rate of postoperative empyema following lung cancer surgery, patient background, surgical procedures, date of empyema onset, treatment, and prognosis of 4772 patients who underwent lung cancer surgery between 2008 and 2012 were investigated.

Postoperative empyema following lung cancer surgery was found in 43 patients (0.9%). The occurrence rate of postoperative empyema was significantly higher in patients with the following factors: male gender, extended surgery such as pneumonectomy, bi-lobectomy and thoracotomy, squamous cell carcinoma, and an advanced pathologic stage of II and above. Chest drainage, video-assisted thoracic surgery debridement, fenestration, and thoracoplasy were performed, where 29 patients were cured (67.5%) and 5 patients (11.6%) died from thoracic empyema-related complications. Nine patients were not cured and died due to cancer or other diseases during treatment. When comparing cured and non-cured patients, it is indicated that squamous cell carcinoma, administration of steroids, history of interstitial pneumonia, presence of bronchial stump fistula, exacerbation of interstitial pneumonia and presence of non-fermenting Gram-negative bacilli led to a significantly low prognosis. The five-year overall survival rate was 34.9%.


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