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Pneumothorax-II

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Subcostal Specimen Removal in Completely Portal Robotic Lobectomy

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Published on: April 19, 2024

Prophylactic fat-free diet in patients undergoing lobectomy for lung cancer does not decrease postoperative

Miao Zhang¹, Wenbin Wu, Ruoran Li

¹Department of Thoracic Surgery, Southeast University School of Medicine, Jiangsu, Xuzhou 221009, People's Republic of China.

Journal of B.U.ON. : Official Journal of the Balkan Union of Oncology

|October 25, 2020

Summary

A prophylactic fat-free diet did not reduce chylothorax incidence after lung cancer lobectomy. Neoadjuvant therapy increased risk, while surgeon experience decreased it, suggesting these factors are key for preventing this complication.

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Area of Science:

Thoracic Surgery
Surgical Oncology
Gastroenterology

Background:

Chylothorax is a rare but serious complication following thoracic surgery, particularly lobectomy for lung cancer.
Effective preventive measures for chylothorax after lobectomy remain limited.
Systemic lymph node dissection (SLND) is often performed concurrently with lobectomy for lung cancer, potentially increasing chylothorax risk.

Purpose of the Study:

To investigate the efficacy of a prophylactic fat-free diet in reducing the incidence of chylothorax after thoracoscopic lobectomy and SLND for lung cancer.
To identify predictive factors for chylothorax development in patients undergoing lobectomy for lung cancer.

Main Methods:

A retrospective case-control study involving patients who underwent lobectomy and SLND for primary non-small cell lung cancer between January 2015 and December 2017.
Patients were divided into a prophylactic group (fat-free diet pre- and post-surgery) and a control group (normal diet).
Logistic regression analysis was used to determine factors associated with chylothorax incidence.

Main Results:

The prophylactic fat-free diet group exhibited reduced intraoperative blood loss, lower postoperative drainage volume, and shorter chest tube duration compared to the control group.
Despite these benefits, the incidence of chylothorax was similar between the two groups (2.6% vs. 6.4%, p=0.207).
Multivariate analysis identified neoadjuvant therapy as an independent risk factor (OR=9.257) and high surgeon experience as a protective factor (OR=0.129) for chylothorax.

Conclusions:

A prophylactic fat-free diet does not appear to decrease the incidence of chylothorax following lobectomy.
Neoadjuvant therapy and surgeon experience are significant independent predictors of chylothorax after lobectomy.
Further well-designed clinical trials are necessary to validate these findings and explore alternative preventive strategies.