Efficacy and Safety of Pleurodesis Using Platelet-Rich Plasma and Fibrin Glue in Management of Postoperative Chylothorax After Esophagectomy
| Autor: | Mostafa Mehrabibahar, Daryoush Hamidi Alamdari, Shahariar Azizi, Ghodratollah Maddah, Soudabeh Shahidsales, Ahmad Nejad Rahim, Mehdi Asadi |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Fibrin Tissue Adhesive 030204 cardiovascular system & hematology Chylothorax Thoracic duct Thoracic Duct 03 medical and health sciences 0302 clinical medicine Postoperative Complications medicine Humans Fibrin glue Ligation Pleurodesis Aged business.industry Platelet-Rich Plasma Postoperative complication Perioperative Middle Aged medicine.disease Surgery Esophagectomy medicine.anatomical_structure Treatment Outcome 030228 respiratory system Anesthesia Female business Abdominal surgery Follow-Up Studies |
| Zdroj: | World journal of surgery. 42(4) |
| ISSN: | 1432-2323 |
| Popis: | Chylothorax is by definition a collection of lymphatic fluids in the pleural cavity because of leakage from main thoracic duct or its tributaries. It is an uncommon but serious postoperative complication in esophageal cancer patients. There is no standard therapeutic algorithm for chylothorax because no prospective or randomized trials have yet been performed to evaluate the available treatment options. The aim of this study was to evaluate the efficacy of pleurodesis with a combination of platelet-rich plasma (PRP) and fibrin glue to the treatment of chylothorax after trans-hiatal esophagectomy. We randomly allocated 52 consecutive esophageal cancer patients with postoperative chylothorax who did not respond to conservative management to either PRP fibrin glue pleurodesis or surgical thoracic duct ligation. 26 patients in each group were treated with PRP fibrin glue pleurodesis or surgical thoracic duct ligation in order to control chylothorax. Perioperative data, including success rate and complications of both interventions, were analyzed. Two groups were similar in terms of patients’ demographics and tumor characteristics. All 26 patients in pleurodesis group (100%) and 20 patients in surgery group (76.9%) were successfully treated (p = 0.009). Seven patients (26.92%) in pleurodesis group required a second application of PRP fibrin glue after a week. The mean length of hospital stay was 53.50 ± 16.662 days in surgery group and 36.04 ± 8.224 days in pleurodesis group (p |
| Databáze: | OpenAIRE |
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