Prognostic indicators of the development of persisting pleural effusion after video-assisted and open lobectomy for lung cancer

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INTRODUCTION: The work is devoted to the problem of predicting the development of persisting pleural effusion (PPE) after lobectomy, which is an important part of modern thoracic surgery, since it concerns the immediate outcomes of surgical treatment of lung cancer.

AIM: To determine the frequency of PPE development in the groups of video-assisted thoracoscopic (VATS) and open lobectomy and to determine prognostic indicators of PPE development.

MATERIALS AND METHODS: The analysis included patients (n = 78) who underwent open lobectomy with mediastinal lymph node dissection in the period from March 01, 2023 to November 10, 2023 (n = 45; 58%), as well as patients who underwent VATS lobectomy with mediastinal lymph node dissection in the period from January 01, 2022 to January 01, 2024 (n = 33; 42%). In 30 cases, a complication was recorded — PPE.

RESULTS: The frequency of PPE in the group of patients with open lobectomy was 22/45 (49%) versus 8/33 (24%) in the group with VATS lobectomy. In patients after VATS, the chest tube was removed earlier compared to those who underwent open lobectomy (p = 0.012). The threshold values were determined for significant prognostic indicators: neutrophil-lymphocyte index on day 4 — 2.11 (p = 0.003), protein in the drainage fluid on day 2 — 14.2 g/l (p = 0.002).

CONCLUSION: Patients with VATS lobectomy had a lower incidence and duration of PPE, which, in turn, determined a shorter hospital stay. Multivariate analysis identified prognostic indicators, the excess of threshold values of which is associated with the PPE development: neutrophil-lymphocyte index on day 4 and the amount of protein in the pleural fluid on day 2.

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作者简介

Evgeny Toneev

Regional Clinical Oncological Dispensary; Ulyanovsk State University

Email: e.toneev@inbox.ru
ORCID iD: 0000-0001-8590-2350
SPIN 代码: 2236-3277

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Ulyanovsk; Ulyanovsk

Roman Shagdaleev

Regional Clinical Oncological Dispensary; Ulyanovsk State University

编辑信件的主要联系方式.
Email: roman2000shagdaleev@gmail.com
ORCID iD: 0009-0004-0218-666X
SPIN 代码: 6566-9671
俄罗斯联邦, Ulyanovsk; Ulyanovsk

Oleg Pikin

National Medical Research Center for Radiology

Email: pikin_ov@mail.ru
ORCID iD: 0000-0001-6871-6804
SPIN 代码: 2381-5969

MD, Dr. Sci. (Medicine), Professor

俄罗斯联邦, Moscow

Alexander Martynov

Regional Clinical Oncological Dispensary

Email: orimpik2006@rambler.ru
ORCID iD: 0000-0003-4662-9886
SPIN 代码: 6726-7147

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Ulyanovsk

Ruslan Lisyutin

Regional Clinical Oncological Dispensary

Email: liss11020@mail.ru
ORCID iD: 0000-0002-4304-5896
SPIN 代码: 8193-2683
俄罗斯联邦, Ulyanovsk

Ayrat Zulkarnyaev

Regional Clinical Oncological Dispensary

Email: traumatolog_416@mail.ru
ORCID iD: 0000-0002-1028-2879
SPIN 代码: 6947-4819
俄罗斯联邦, Ulyanovsk

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