Abstract 250P
Background
Pleural effusion and air leakage through the chest tube following lobectomy are important indicators for the management of patients who have undergone surgical resection for lung cancer. However, when procedures such as fissure division and mediastinal lymph node dissection are performed, they can lead to an increase in pleural effusion and air leakage. Taurolidine has previously been used as a pleurodesis agent following lung resection, or irrigation of empyema cavities. Based on these findings, this study aimed to investigate whether intraoperative Taurolidine irrigation is effective in reducing pleural effusion and air leakage after lung cancer surgery.
Methods
Patients aged 19 years or older for lobectomy and lymphadenectomy in lung cancer patients were included in this study, and exclusion criteria encompassing patients with severe end-organ diseases. 40 allocated to the study group and 40 to the control group through random assignment. The test drug consisted of 250 ml of Taurolidine 2% solution mixed with 250 ml of normal saline, while the control group received 500 ml of normal saline during intrathoracic lavage performed just after lobectomy. Quantitative measurements were taken for both the amount of pleural effusion drained through the chest tube and the degree of air leakage.
Results
Out of the 100 patients, 9 patients who undergo pneumonectomy or sublobar resection were excluded. The remaining patients were then divided into 35 in the test group and 36 in the control group. Preoperative demographic characteristics and intra-operative findings were comparable between both groups. The duration of chest tube duration was 5.0±2.2 days for the study group and 6.8±3.3 days for the control group (p=0.013), with the total drainage amount being 1470±1040 ml for the study group and 2367±1205 ml for the control group (p=0.001).
Conclusions
Intraoperative irrigation with a taurolidine reduced the duration of air leakage and decreased the pleural effusion amount. While a large-scale study would be necessary, lavaging the thoracic cavity with taurolidine after lobectomy in lung cancer patients could potentially aid in the early removal of chest tubes post-surgery.
Clinical trial identification
This study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Yonsei University Wonju College of Medicine (IRB No. CR120044 on 22 september 2020).
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.