Clinical Research Papers:
Postoperative empyema following lung cancer surgery
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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
Noriyuki Matsutani, email: firstname.lastname@example.org
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
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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