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Negative impact of chemical pleurodesis on postoperative pulmonary function for managing prolonged air leakage after segmentectomy

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Abstract

Objective

Prolonged air leakage (PAL) is the most common postoperative complication after segmentectomy and chemical pleurodesis (CP) is one of the common procedures for managing PAL. However, the impact of CP on postoperative pulmonary function remains unclear.

Methods

We performed a propensity score matching analysis for postoperative pulmonary function in lung cancer patients who underwent segmentectomy. The percentage of postoperative functional change of forced vital capacity (δFVC) and forced expiratory volume in 1 s (δFEV1.0) at postoperative 6 and 12 months were compared between patients who were managed for PAL by CP (CP group, n = 21) and those who did not receive CP (non-CP, n = 21). The predicted δFVC and δFEV1.0 after segmentectomy and lobectomy were also assessed to evaluate the loss of preserved lung function.

Results

δFVC and δFEV1.0 in the CP group were confirmed by a significantly larger decline in postoperative pulmonary function than that seen in the non-CP group at postoperative 6 and 12 months (δFVC at 6 months, − 21.1% versus − 5.1%, − 20.8% versus − 6.8% at 12 months, δFEV1.0 at 6 months, − 19.1% versus − 7.2%, − 19.6% versus − 9.7%, at 12 months, p < 0.05 respectively). Both δFVC and δFEV1.0 in the CP group were significantly lower than those predicted after segmentectomy (p < 0.01). They were not statistically different from the values predicted if lobectomy was performed.

Conclusions

CP after segmentectomy caused the same amount of loss in pulmonary function that was predicted if lobectomy was performed. The benefit of segmentectomy compared to lobectomy for preservation of pulmonary function is impaired by CP.

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Abbreviations

CP:

Chemical pleurodesis

FVC:

Forced vital capacity

FEV1.0 :

Forced expiratory volume in 1 s

PAL:

Prolonged air leakage

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Acknowledgments

This study was supported in part by a Grant–in–Aid for Cancer Research from the Ministry of Health, Labor and Welfare of Japan and the Smoking Research Foundation.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Juntendo University School of Medicine, 1-3, Hongo 3 cho-me, Bunkyo-ku, Tokyo, 113-8431, Japan

    Tatsuo Maeyashiki, Kazuya Takamochi, Takeshi Matsunaga, Shiaki Oh & Kenji Suzuki

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  1. Tatsuo Maeyashiki
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  2. Kazuya Takamochi
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  3. Takeshi Matsunaga
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  4. Shiaki Oh
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  5. Kenji Suzuki
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Correspondence to Tatsuo Maeyashiki.

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Maeyashiki, T., Takamochi, K., Matsunaga, T. et al. Negative impact of chemical pleurodesis on postoperative pulmonary function for managing prolonged air leakage after segmentectomy. Gen Thorac Cardiovasc Surg 69, 707–715 (2021). https://doi.org/10.1007/s11748-020-01534-9

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  • DOI: https://doi.org/10.1007/s11748-020-01534-9

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