Prophylactic octreotide does not reduce the incidence of postoperative chylothorax following lobectomy: Results from a retrospective study.

Szczegóły
Abstrakt

Tytuł:: Prophylactic octreotide does not reduce the incidence of postoperative chylothorax following lobectomy: Results from a retrospective study.
Autorzy:: Zhang C; Department of Thoracic Surgery, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing.
Zhang H; Department of Thoracic Surgery, Xuzhou Central Hospital Affiliated to Southeast University, Xuzhou, China.
Wu W; Department of Thoracic Surgery, Xuzhou Central Hospital Affiliated to Southeast University, Xuzhou, China.
Liu D; Department of Thoracic Surgery, Xuzhou Central Hospital Affiliated to Southeast University, Xuzhou, China.
Yang D; Department of Thoracic Surgery, Xuzhou Central Hospital Affiliated to Southeast University, Xuzhou, China.
Zhang M; Department of Thoracic Surgery, Xuzhou Central Hospital Affiliated to Southeast University, Xuzhou, China.
Lu C; Department of Thoracic Surgery, Xuzhou Central Hospital Affiliated to Southeast University, Xuzhou, China.
Źródło:: Medicine [Medicine (Baltimore)] 2019 Jul; Vol. 98 (29), pp. e16599.
Typ publikacji:: Journal Article; Observational Study
Język:: English
Imprint Name(s):: Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins
MeSH Terms:: Antineoplastic Agents, Hormonal/*therapeutic use
Chylothorax/*prevention & control
Lung Neoplasms/*drug therapy
Lung Neoplasms/*surgery
Octreotide/*therapeutic use
Pneumonectomy/*adverse effects
Adult ; Aged ; Aged, 80 and over ; Chest Tubes ; Chylothorax/etiology ; Diet, Fat-Restricted ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Patient Readmission ; Pleural Effusion ; Postoperative Complications/prevention & control ; Retrospective Studies ; Risk Factors ; Time Factors
References:: J Paediatr Child Health. 2018 Aug;54(8):840-847. (PMID: 29602276)
Surg J (N Y). 2018 Oct 18;4(4):e182-e187. (PMID: 30474064)
Int J Surg. 2017 Mar;39:16-22. (PMID: 28115296)
Eur J Cardiothorac Surg. 2016 Jan;49(1):18-24. (PMID: 25732972)
J Thorac Cardiovasc Surg. 2014 Aug;148(2):637-43. (PMID: 24529729)
N Engl J Med. 2013 Sep 19;369(12):1134-42. (PMID: 24047062)
Interact Cardiovasc Thorac Surg. 2017 Jul 1;25(1):122-124. (PMID: 28379438)
Surg Oncol. 2010 Jun;19(2):e71-7. (PMID: 19500971)
Surgery. 2016 Jan;159(1):358-65. (PMID: 26603846)
J Am Coll Surg. 2014 Jan;218(1):108-12. (PMID: 24211053)
Eur J Cardiothorac Surg. 2016 Sep;50(3):411-5. (PMID: 27174549)
J Thorac Dis. 2013 Dec;5(6):851-4. (PMID: 24409365)
Asian Cardiovasc Thorac Ann. 2017 Jan;25(1):6-12. (PMID: 27920229)
World J Surg. 2014 Jan;38(1):60-7. (PMID: 24158313)
World J Surg. 2019 Jul;43(7):1788-1801. (PMID: 30798417)
World J Surg. 2014 Aug;38(8):2039-45. (PMID: 24705804)
Eur J Cardiothorac Surg. 2012 May;41(5):1083-7; discussion 1087. (PMID: 22362624)
J Korean Med Sci. 2005 Dec;20(6):947-51. (PMID: 16361802)
Interact Cardiovasc Thorac Surg. 2015 Jun;20(6):848-54. (PMID: 25784759)
Chest. 1992 Aug;102(2):586-91. (PMID: 1643953)
Ann Thorac Surg. 2015 Jul;100(1):297-9. (PMID: 26140770)
Ann Thorac Surg. 2014 Jul;98(1):232-5; discussion 235-7. (PMID: 24811982)
Ann Surg. 2013 Jan;257(1):8-14. (PMID: 23235393)
Future Oncol. 2018 Mar;14(6s):33-40. (PMID: 29400559)
Thorac Surg Clin. 2015 Nov;25(4):523-8. (PMID: 26515952)
Ann Thorac Surg. 2013 Nov;96(5):1740-5; discussion 1745-6. (PMID: 23987895)
JAMA Surg. 2013 Aug;148(8):755-62. (PMID: 23784299)
J Thorac Dis. 2016 Aug;8(8):2281-3. (PMID: 27621892)
Anesthesiol Clin. 2017 Jun;35(2):327-339. (PMID: 28526153)
Ann Thorac Surg. 2015 Feb;99(2):393-8. (PMID: 25497070)
J Thorac Cardiovasc Surg. 2015 Dec;150(6):1508-14.e2. (PMID: 26092506)
Substance Nomenclature:: 0 (Antineoplastic Agents, Hormonal)
RWM8CCW8GP (Octreotide)
Entry Date(s):: Date Created: 20190724 Date Completed: 20190801 Latest Revision: 20221005
Update Code:: 20240105
PubMed Central ID:: PMC6708833
DOI:: 10.1097/MD.0000000000016599
PMID:: 31335742
: Czasopismo naukowe

Full Text Finder

Chylothorax after lobectomy is common, lacking reliable preventive measures. Octreotide is widely used for treatment of chyle leakage, but its role in preventing chylothorax has not been estimated. The aim of this study was to evaluate whether prophylactic octreotide could reduce the incidence of postoperative chylothorax.Patients who underwent lobectomy for lung cancer from January 2016 to September 2018 were retrospectively reviewed. The cases in prophylactic group received octreotide 1 day before the surgery until removal of chest tubes, while those in the control group did not use it unless the diagnosis of chylothorax.A total of 379 patients were enrolled, with 190 patients in control and 189 cases in prophylactic group. Octreotide was well tolerated in patients who received this agent. No 30-day mortality was indicated. Seven cases in control (3.7%, 7/190) and 3 cases in prophylactic group (1.6%, 3/189) with chylothorax were observed (P = .337). The patients in prophylactic group showed shorter duration of chest drainage ([3.6 ± 1.6] days vs [4.1 ± 2.0] days, P = .006) and reduced drainage volume ([441.8 ± 271.1] mL vs [638.7 ± 463.3] mL, P < .001). In addition, they showed similar stations and numbers of dissected lymph nodes, surgery-related complications, and postoperative hospital stay. Besides, 11 (5.8%, 11/190) patients in control and 6 (3.2%, 6/189) cases in the prophylactic group were readmitted for pleural effusion needing reinsertion of chest tubes (P = .321). Moreover, multivariable logistic analysis showed that induction therapy (odds ratio [OR] =12.03; 95% confidence interval [CI] 3.15-46.03, P < .001) was a risk factor, while high-volume experience of the surgeon (OR = 0.23; 95% CI 0.06-0.97, P = .045) was a preventive factor of surgery-related chylothorax. Additionally, prophylactic octreotide (OR = 0.18; 95% CI 0.11-0.28, P < .001) and perioperative low-fat diet (OR = 0.46; 95% CI 0.29-0.73, P = .001) were negatively associated with the drainage volume of pleural effusion. Furthermore, high-volume experience of the surgeon (OR = 6.03; 95% CI 1.30-27.85, P = .021) and induction therapy (OR = 8.87; 95% CI 2.97-26.48, P < .001) were risk factors of unplanned readmission.Prophylactic octreotide does not reduce the incidence of postoperative chylothorax or unplanned readmission following anatomic lobectomy. The routine application of octreotide should not be recommended. High-quality trials are required to validate these findings.

Informacja