Physiology of pleural space after pulmonary resection

Paone, Gregorino; Rose, Giulia De; Giudice, Giulia Claire; Cappelli, Sara

doi:10.21037/jxym.2018.03.01

Cited by 7 publications

(12 citation statements)

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“…Pleural effusion may occur due to an imbalance between hydrostatic pressure and osmotic pressure in lung capillaries and interstitium. As residual neuromuscular blockade inhibits respiratory muscular function and lung expansion, the negative pressure in the pleural cavity may be reduced, which could lead to pleural effusion [22,23]. A possible explanation for our results is that post-operative residual neuromuscular blockade is reduced by sugammadex compared to neostigmine; hence pleural effusion was also reduced.…”

Section: Discussionmentioning

confidence: 72%

Effects of Sugammadex on Post-Operative Pulmonary Complications in Laparoscopic Gastrectomy: A Retrospective Cohort Study

Han

Ryu

Koo

et al. 2020

JCM

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The use of sugammadex can reduce post-operative residual neuromuscular blockade, which is known to increase the risk of post-operative respiratory events. However, its effect on post-operative pulmonary complications is not obvious. This study was performed to evaluate the effects of sugammadex on post-operative pulmonary complications in patients undergoing laparoscopic gastrectomy between 2013 and 2017. We performed propensity score matching to correct for selection bias. Post-operative pulmonary complications (i.e., pneumonia, respiratory failure, pleural effusion, atelectasis, pneumothorax, and aspiration pneumonitis) were evaluated from the radiological and laboratory findings. We also evaluated admission to the intensive care unit after surgery, re-admission or an emergency room visit within 30 days after discharge, length of hospital stay, re-operation, and mortality within 90 days post-operatively as secondary outcomes. In the initial cohort of 3802 patients, 541 patients were excluded, and 1232 patients were analyzed after propensity score matching. In the matched cohort, pleural effusion was significantly reduced in the sugammadex group compared to the neostigmine group (neostigmine 23.4% vs. sugammadex 18%, p = 0.02). Other pulmonary complications and secondary outcomes were not significantly different between the groups. In comparison to neostigmine, the use of sugammadex was associated with a lower incidence of post-operative pleural effusion in laparoscopic gastrectomy.

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Section: Discussionmentioning

confidence: 72%

Effects of Sugammadex on Post-Operative Pulmonary Complications in Laparoscopic Gastrectomy: A Retrospective Cohort Study

Han

Ryu

Koo

et al. 2020

JCM

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“…In fact, the volumetric changes of LLL were also higher in lobectomy ( n = 5, 150.4% ± 68.0%) than in segmentectomy ( n = 11, 118.4% ± 26.3%), but no significant difference was obtained ( p = 0.58). Over distension is one of the most feared complications of lung resection as it may not only cause injury to the lung, but it could also cause three major complications: air leak, hydrothorax and lung edema 24 . Tissue injury to the lung alveolar derived from chronic inflammation could lead to the loss of the alveolar epithelial cells, damage or loss of the basement membrane and endothelial cells, and at the most severe end of the spectrum a complete collapse of the collagen and elastic support framework of the alveoli 25 .…”

Section: Discussionmentioning

confidence: 99%

Subsegmental resection preserves regional pulmonary function: A focus on thoracoscopy

et al. 2021

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Background The aim of this study was to evaluate regional postoperative preserved pulmonary function (PPPF) and three‐dimensional (3D) volumetric changes according to the number of resected subsegments and investigate the factors that most affected pre‐/post PPPF. Methods Patients who underwent thoracoscopic lobectomy (n = 73), and segmentectomy (n = 87) were eligible for inclusion in the study. They were classified according to the number of resected subsegments which ranged from 1 to 10. The percentage of pre‐/postoperative forced expiratory volume in 1 s (FEV1) was used for comparison. Furthermore, lung volumetric changes were calculated using 3D computed tomography (CT) volumetry. Results The percentage of pre‐/postoperative EFV1 between 4 and 5–7 and between 5–7 and 10 were significant (p = 0.03 and p < 0.01, respectively), but not between 1–2 to 4 (p = 0.99). The difference between volumetric changes in the left lower lobe of patients with a number of resected subsegments was significant (p < 0.01). On univariate and multivariate analyses, chronic inflammation was significant for decrease in recovery percentages. When the PPPF was compared among resected subsegments, it gradually decreased with an increase in the number of patients without a postoperative procrastination of inflammation (p < 0.01). Conclusions Segmentectomy is feasible and useful for PPPF. Even a relatively large‐volume resection procedure where 5–7 subsegments are resected can preserve pulmonary function. Chronic inflammation was statistically identified as a risk factor for postoperative preserved pulmonary function. Key points

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“…Following resection in thoracic surgery, changes occur in the pneumonectomy area, which is reduced by the rising diaphragm (Paone, Rose and Giudice, 2018). The space which forms after pneumonectomy is called the postoperative pleural space.…”

Section: Pathophysiology Of Thoracic Surgerymentioning

confidence: 99%

Thoracic Surgery and Nursing Care

Korkmaz

YEŞİLYAPRAK

SOFU

2023

Ege Üniversitesi Hemşirelik Fakültesi Dergisi

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Changes in the pathophysiology of the chest after thoracic surgery cause respiratory and heart-related complications. These complications arise in connection with the patient’s physiological characteristics and with the type of surgical intervention. Complications which occur and which cannot be brought under control extend the length of hospital stay and cause an increase in the rates of morbidity and mortality. To reduce and prevent complications, holistic nursing care is important throughout the surgical process. In this way, the patient’s functional life can recover more quickly. Therefore, we will discuss the pathophysiological changes, complications and evidence-based practices for nursing care after thoracic surgery.

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Physiology of pleural space after pulmonary resection

Cited by 7 publications

References 0 publications

Effects of Sugammadex on Post-Operative Pulmonary Complications in Laparoscopic Gastrectomy: A Retrospective Cohort Study

Effects of Sugammadex on Post-Operative Pulmonary Complications in Laparoscopic Gastrectomy: A Retrospective Cohort Study

Subsegmental resection preserves regional pulmonary function: A focus on thoracoscopy

Thoracic Surgery and Nursing Care

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