Postoperative outcomes among patients undergoing thoracostomy tube placement at time of diaphragm peritonectomy or resection during primary cytoreductive surgery for ovarian cancer Journal Article

  

Authors:	Sandadi, S.; Long, K.; Andikyan, V.; Vernon, J.; Zivanovic, O.; Eisenhauer, E. L.; Levine, D. A.; Sonoda, Y.; Barakat, R. R.; Chi, D. S.
Article Title:	Postoperative outcomes among patients undergoing thoracostomy tube placement at time of diaphragm peritonectomy or resection during primary cytoreductive surgery for ovarian cancer
Abstract:	Objective Primary cytoreductive surgery in patients with stage IIIC-IV epithelial ovarian cancer frequently includes diaphragm peritonectomy or resection, which can lead to symptomatic pleural effusions when the resection specimen is ≥ 10 cm. Our objective was to evaluate whether the placement of an intraoperative thoracostomy tube decreased the incidence of symptomatic pleural effusions in these cases. Methods We identified 156 patients who underwent primary debulking surgery involving diaphragm peritonectomy or resection for stage III-IV ovarian cancer from 1/01-12/09. Using standard statistical tests, the incidence of symptomatic pleural effusions and other variables were compared between patients who did and did not have intraoperative chest tubes placed. Results Forty-nine patients had a resected diaphragm specimen ≥ 10 cm in largest dimension; 28 (57%) did not undergo chest tube placement (NCT group) while 21 (43%) did (CT group). Mediastinal lymph node dissection (0% vs 19%, P = 0.028) and liver resections (11% vs 38%, P = 0.037) were higher in the CT group. Postoperatively, 57% of the NCT group developed a moderate or large pleural effusion compared to 19% of the CT group (P = 0.007). Thirteen patients (46%) in the NCT group developed respiratory symptoms requiring either placement of a postoperative chest tube or thoracentesis compared to 3 patients (14%) in the CT group (P = 0.018). Conclusions Diaphragm peritonectomy or resection can often lead to moderate or large pleural effusions that may become symptomatic. In these patients, intraoperative chest tube placement may be considered to decrease the incidence of symptomatic effusions and the need for postoperative chest tube placement or thoracentesis. © 2013 Elsevier Inc. All rights reserved.
Keywords:	thoracostomy; diaphragm surgery; pleural effusions
Journal Title:	Gynecologic Oncology
Volume:	132
Issue:	2
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2014-02-01
Start Page:	299
End Page:	302
Language:	English
DOI:	10.1016/j.ygyno.2013.11.026
PROVIDER:	scopus
PUBMED:	24296344
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84894050754&partnerID=40&md5=a01f23585f3b905c57a78ac9a1d6743e
Notes:	Export Date: 3 March 2014 -- CODEN: GYNOA -- Source: Scopus

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