1
|
Noguera CAL, Lopes AJ, Mathias Filho I, Higa C, Nunes RA, Lima CET, Saito EH. The importance of endobag use with incision-protective devices in VATS lung resection: a preliminary study. BMC Res Notes 2022; 15:158. [PMID: 35538583 PMCID: PMC9092789 DOI: 10.1186/s13104-022-06047-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 04/24/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The advent of new techniques such as video-assisted thoracoscopic surgery (VATS) for the removal of lung segments leads to compression of the surgical specimen, with the possible dissemination of neoplastic cells. The sheer volume of surgeries performed using these techniques has caused many institutions to stop removing the surgical specimen using an endobag, even when retractors/protectors are used in the instrumentalization incision. This study aimed to collect data from patients undergoing lung resection by VATS and analyze the cytopathological results of the collected material. RESULTS A total of 47 endobag fluid samples were collected from patients who underwent VATS. The surgical specimen was subjected to histopathological analysis, and all patients underwent pathological TNM staging. In the cytopathological analyses, only 2 (4.3%) specimens of endobag fluid aspirate were positive for neoplastic cells. In these two cases, the tumors were peripheral, both with diagnoses of moderately differentiated adenocarcinoma and with classifications of T1bN0M0 and T3N0M0. These results indicate that although there is a low incidence of tumor cells in endobag fluid, it is always better to perform surgery using all available protective measures to avoid tumor implantation in the thoracic cavity to the greatest extent possible.
Collapse
Affiliation(s)
- Carlos Andrés Latorre Noguera
- Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil
| | - Agnaldo José Lopes
- Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil. .,Medical Sciences Post-Graduation Program, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Av. Prof. Manoel de Abreu, 444, 2º andar, Vila Isabel, Rio de Janeiro, 20550-170, Brazil.
| | - Ivan Mathias Filho
- Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil.,Hospital Quinta D'Or, Rua Almirante Baltazar, 435, São Cristóvão, Rio de Janeiro, 20941-150, Brazil
| | - Claudio Higa
- Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil
| | - Rodolfo Acatauassú Nunes
- Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil.,Medical Sciences Post-Graduation Program, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Av. Prof. Manoel de Abreu, 444, 2º andar, Vila Isabel, Rio de Janeiro, 20550-170, Brazil
| | - Carlos Eduardo Teixeira Lima
- Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil
| | - Eduardo Haruo Saito
- Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro, 20551-030, Brazil.,Medical Sciences Post-Graduation Program, School of Medical Sciences, State University of Rio de Janeiro (UERJ), Av. Prof. Manoel de Abreu, 444, 2º andar, Vila Isabel, Rio de Janeiro, 20550-170, Brazil.,Hospital Quinta D'Or, Rua Almirante Baltazar, 435, São Cristóvão, Rio de Janeiro, 20941-150, Brazil
| |
Collapse
|
2
|
Zhou J, Liu C, Man S, Lyu M, Liao H, Chen N, Cheng Y, Liu L. Comparison of the clinical benefits for non-small cell lung cancer patients between different volume of pleural lavage fluid following video-assisted thoracoscopic lobectomy and systematic mediastinal lymph node dissection: study protocol for a randomized controlled trial. Trials 2020; 21:232. [PMID: 32106877 PMCID: PMC7047403 DOI: 10.1186/s13063-020-4146-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 02/06/2020] [Indexed: 02/08/2023] Open
Abstract
Background Pleural lavage is regularly performed before closing the chest wall in pulmonary surgeries to prevent pleural implantation of tumor cells and postoperative infection. However, scant data could be found in the literature regarding the optimal regimen for performing pleural lavage. To establish a proper volume of pleural lavage, we herein designed a protocol for a randomized controlled trial. Methods A total of 400 participants with non-small cell lung cancer undergoing video-assisted thoracoscopic surgery (VATS) lobectomy and systematic mediastinal lymph node dissection (MLND) will be randomly assigned to one of two groups: group A (500 mL pleural lavage fluid) and group B (3000 mL pleural lavage fluid). The primary outcomes include the levels of leukocytes, neutrophils, and inflammatory factors on the first postoperative day. The secondary outcomes include (i) the levels of leukocytes, neutrophils, and inflammatory factors on the second and third postoperative days; (ii) the incidence of postoperative fever on the first, second, and third postoperative days; (iii) the volumes of chest drainage within the first 3 operative days, the duration of drainage, and postoperative hospitalization; and (iv) the incidence of postoperative complications (incision infection, pain, atelectasis, hemorrhage, etc.) and the incidence of pleural effusion requiring thoracic puncture or drainage within 30 days after surgery. The main content of the analysis includes effectiveness and safety analysis. We will perform subgroup analyses to identify potential influence factors. Discussion As far as we know, this will be the first randomized controlled trial to compare the clinical outcomes between different volumes of pleural lavage fluid following VATS and MLND. Findings from this trial will determine the appropriate amount of pleural lavage before chest wall closure. Trial registration This study was registered with the Chinese Clinical Trial Registry ( on 17 March 2019. ChiCTR 1900021950).
Collapse
Affiliation(s)
- Jian Zhou
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.,West China School of Medicine, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Chengwu Liu
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.,West China School of Medicine, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Shulei Man
- West China School of Medicine, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Mengyuan Lyu
- West China School of Medicine, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Hu Liao
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.,West China School of Medicine, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Nan Chen
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.,West China School of Medicine, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Yuhui Cheng
- West China School of Medicine, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China
| | - Lunxu Liu
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China. .,Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, No. 37, Guoxue Alley, Chengdu, 610041, Sichuan, China.
| |
Collapse
|