Prophylactic Intraoperative Pneumoperitoneum Decreases Pleural Space Problems after Lower Lobectomy or Bilobectomy of the Lung

Okur, Erdal; Arisoy, Yücel; Baysungur, Volkan; Gokce, Mertol; Sevilgen, Gökçen; Ergene, Gokhan; Halezeroğlu, Semih

doi:10.1055/s-2008-1039108

Cited by 12 publications

(13 citation statements)

References 8 publications

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“…Die Zwerchfellparalyse war innerhalb von 30 bis 60 Tagen nach Ablation reversibel [62]. Die intraoperative Anlage eines Pneumoperitoneums konnte bei Patienten nach Unterlappen-oder unterer Bilobektomie die Häufigkeit einer pleuralen Residualhöhle von 27 auf 3 % reduzieren [63]. Besteht die Gefahr einer pleuralen Residualhöhle nach Lungen-und Zwerchfellresektion (z.…”

Section: Kombinationsverfahrenunclassified

Die pleurale Residualhöhle nach Lungenresektion

Lesser

2019

Zentralbl Chir

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ZusammenfassungBei ca. 10% der Patienten kommt es nach anatomischer Lungenresektion zu einer pleuralen Residualhöhle. Die häufigsten Ursachen sind die Lungenparenchymerkrankung mit verminderter Compliance und die Luftfistel. Tritt bis zum Ende der 4. Woche keine Komplikation auf, ist mit einem unkomplizierten Verlauf (Resorption der Luft) zu rechnen. Bei einer Infektion der Höhle und einer bronchopleuralen Fistel besteht die Gefahr der inneren Aspiration mit Ausbildung einer lebensbedrohlichen Pneumonie. In diesen Fällen ist ein operatives Vorgehen indiziert. Die Wahl des operativen Verfahrens ist eine individuelle Entscheidung, wobei der Allgemeinzustand, Nebenerkrankungen, die Mobilität und Motivation des Patienten, die respiratorische Funktion, die Qualität des Lungengewebes, das Grundleiden sowie dessen Prognose und lokale wie auch systemische Auswirkungen der chronischen Höhleninfektion berücksichtigt werden müssen. Für die operative Therapie einer pleuralen Residualhöhle stehen folgende Verfahren zur Verfügung: Pleuradrainage, Pneumoperitoneum, Pleurazelt, Dekortikation der Lunge, Muskeltransposition, Thorakoplastik, Thorakostoma, Kombinationsverfahren. Die Drainage- oder Dekortikationsverfahren setzen eine ausdehnungsfähige Restlunge voraus. Eine besondere Herausforderung stellt das Postpneumonektomieempyem dar. Zur Vermeidung einer pleuralen Residualhöhle können bereits beim Ersteingriff prophylaktische Maßnahmen (Pleurazelt, Pneumoperitoneum, N.-phrenicus-Blockade) erfolgen.

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Section: Kombinationsverfahrenunclassified

Die pleurale Residualhöhle nach Lungenresektion

Lesser

2019

Zentralbl Chir

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“…After major lung surgery, the occurrence of residual pleural space, continuous alveolar air leak, and prolonged chest tube drainage results in pleuropulmonary infections or a prolonged hospital stay. [1,2] Prolonged chest tube drainage after resections increases the cost of hospitalization by using antibiotics, extending the hospital stay, and, in some cases, mandating reoperations. [2] Residual pleural spaces are more common after upper lobe resections.…”

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“…[1,2] Prolonged chest tube drainage after resections increases the cost of hospitalization by using antibiotics, extending the hospital stay, and, in some cases, mandating reoperations. [2] Residual pleural spaces are more common after upper lobe resections. [2] The presence of residual space without air leak is not a serious problem because of the high percentage of spontaneous remission.…”

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confidence: 99%

“…[2] The presence of residual space without air leak is not a serious problem because of the high percentage of spontaneous remission. [2] The application of glues, patches, stapling devices for large incomplete fissures, peeling of restrictive pleura, pleural tenting, decortication of restrictive pleural peel, sectioning of the lower pulmonary ligament, thoracoplasty, and crushing of the phrenic nerve are some useful maneuvers. [1][2][3] Physiotherapy, pleurodesis, and the use of the Heimlich valve are all possibilities as conservative approaches.…”

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confidence: 99%

“…[2] The application of glues, patches, stapling devices for large incomplete fissures, peeling of restrictive pleura, pleural tenting, decortication of restrictive pleural peel, sectioning of the lower pulmonary ligament, thoracoplasty, and crushing of the phrenic nerve are some useful maneuvers. [1][2][3] Physiotherapy, pleurodesis, and the use of the Heimlich valve are all possibilities as conservative approaches. [1] Pneumoperitoneum is also an effective maneuver as has been reported by many authors.…”

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Effects on inflammatory cytokines and oxidative stress markers of pneumoperitoneum performed after thoracotomy in rats

Ergin¹

2012

Turk Gogus Kalp Dama

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Bu çalışmada pnömoperiton işleminin torakotomi sonrası inflamasyon üzerine etkileri araştırıldı. Ça lış ma pla nı: Otuz iki adet 280-320 g ağırlığında Wistar cinsi erkek sıçan her birinde sekiz sıçan olan dört gruba ayrıldı. Kontrol grubunda sıçanlara sadece anestezi uygulandı. Torakotomi grubunda sol torakotomi sonrası 30 dakika periyodlu otomatik retraktör yerleştirildi. Pnömoperiton grubunda batın içerisine 5 ml oda havası enjekte edildi. Torakotomi + pnömoperiton grubunda ise torakotomi uygulandı ve batın içerisine 5 ml oda havası enjekte edildi. Yirmi dört saat sonra tüm gruplardan kan ve akciğer örnekleri alındı ve-80 °C'de saklandı. Bul gu lar: Torakotomi grubunda tümör nekroz faktörüalpha, interlökin-6 ve protein karbonil düzeyleri kontrol grubundan anlamlı olarak daha yüksek idi fakat pnömoperiton ve torakotomi + pnömoperiton grupları arasında fark yok idi. So nuç: Torakotomi sonrasında yapılan pnömoperiton işlemi torakotominin neden olduğu inflamatuvar reaksiyonu ve oksidatif stresi artırıcı bir etki yapmamaktadır. Pnömoperiton efektif ve kolay uygulanan bir yöntemdir. Anah tar söz cük ler: Sitokinler; oksidatif stres belirteçleri; pnömoperiton; torakotomi. Background:This study aims to investigate the effects of pneumoperitoneum on inflammation after thoracotomy. Methods: Thirty-two male Wistar type rats weighing 280-320 g were divided into four groups of eight rats each. In the control group rats were only anaesthetized. In thoracotomy group an automatic retractor was inserted for a 30-minute period after left thoracotomy. In the pneumoperitoneum group, 5 ml of room air was injected intraperitoneally. In the thoracotomy + pneumoperitoneum group, thoracotomy was performed and 5 ml of room air was injected intraperitoneally. Blood and lung tissue samples were taken at the 24 th hour in all groups and were stored at-80 °C. Results: In the thorocotomy group, the tumor necrosis factor-alfa, interleukin-6 and protein carbonyl levels were significantly higher than in the control group but no difference was found between the pneumoperitoneum and the thoracotomy + pneumoperitoneum groups. Conclusion: Pneumoperitoneum performed after thoracotomy does not increase the inflammatory reaction and oxidative stress caused by thoracotomy. Pneumoperitoneum is an effective and easily performed method.

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Side Effects of Surgical Therapy for Non-Small Cell Lung Cancer: Prevention and Treatment

Aigner,

Müller

2023

Side Effects of Cancer Therapy

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Prophylactic Intraoperative Pneumoperitoneum Decreases Pleural Space Problems after Lower Lobectomy or Bilobectomy of the Lung

Abstract: Artificial prophylactic intraoperative pneumoperitoneum is a simple and safe procedure that decreases the postoperative amount of fluid drainage, residual pleural space, duration of chest tube drainage, and hospital stay.

Cited by 12 publications

References 8 publications

Die pleurale Residualhöhle nach Lungenresektion

Die pleurale Residualhöhle nach Lungenresektion

Effects on inflammatory cytokines and oxidative stress markers of pneumoperitoneum performed after thoracotomy in rats

Side Effects of Surgical Therapy for Non-Small Cell Lung Cancer: Prevention and Treatment

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