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

Samith Sandadi, Kara Long, Vaagn Andikyan, Jessica Vernon, Oliver Zivanovic, Eric L. Eisenhauer, Douglas A. Levine, Yukio Sonoda, Richard R. Barakat, Dennis S. Chi

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)299-302
Number of pages4
JournalGynecologic Oncology
Volume132
Issue number2
DOIs
StatePublished - Feb 2014
Externally publishedYes

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Thoracostomy
Diaphragm
Ovarian Neoplasms
Chest Tubes
Pleural Effusion
Incidence
Lymph Node Excision
Liver

Keywords

  • Diaphragm surgery
  • Pleural effusions
  • Thoracostomy

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Postoperative outcomes among patients undergoing thoracostomy tube placement at time of diaphragm peritonectomy or resection during primary cytoreductive surgery for ovarian cancer. / Sandadi, Samith; Long, Kara; Andikyan, Vaagn; Vernon, Jessica; Zivanovic, Oliver; Eisenhauer, Eric L.; Levine, Douglas A.; Sonoda, Yukio; Barakat, Richard R.; Chi, Dennis S.

In: Gynecologic Oncology, Vol. 132, No. 2, 02.2014, p. 299-302.

Research output: Contribution to journalArticle

Sandadi, S, Long, K, Andikyan, V, Vernon, J, Zivanovic, O, Eisenhauer, EL, Levine, DA, Sonoda, Y, Barakat, RR & Chi, DS 2014, 'Postoperative outcomes among patients undergoing thoracostomy tube placement at time of diaphragm peritonectomy or resection during primary cytoreductive surgery for ovarian cancer', Gynecologic Oncology, vol. 132, no. 2, pp. 299-302. https://doi.org/10.1016/j.ygyno.2013.11.026
Sandadi, Samith ; Long, Kara ; Andikyan, Vaagn ; Vernon, Jessica ; Zivanovic, Oliver ; Eisenhauer, Eric L. ; Levine, Douglas A. ; Sonoda, Yukio ; Barakat, Richard R. ; Chi, Dennis S. / Postoperative outcomes among patients undergoing thoracostomy tube placement at time of diaphragm peritonectomy or resection during primary cytoreductive surgery for ovarian cancer. In: Gynecologic Oncology. 2014 ; Vol. 132, No. 2. pp. 299-302.
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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.",
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T1 - Postoperative outcomes among patients undergoing thoracostomy tube placement at time of diaphragm peritonectomy or resection during primary cytoreductive surgery for ovarian cancer

AU - Sandadi, Samith

AU - Long, Kara

AU - Andikyan, Vaagn

AU - Vernon, Jessica

AU - Zivanovic, Oliver

AU - Eisenhauer, Eric L.

AU - Levine, Douglas A.

AU - Sonoda, Yukio

AU - Barakat, Richard R.

AU - Chi, Dennis S.

PY - 2014/2

Y1 - 2014/2

N2 - 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.

AB - 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.

KW - Diaphragm surgery

KW - Pleural effusions

KW - Thoracostomy

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