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Pulmonary morbidity related to diaphragm surgery performed for gynecological cancers

OBJECTIVE: To evaluate pulmonary morbidity related to diaphragm surgery performed for gynecological cancers and to identify the impact of transdiaphragmatic thoracotomy. MATERIALS AND METHODS: We reviewed clinical and pathologic data of 232 women who had undergone diaphragm surgery as a part of cyto...

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Autores principales: Durmuş, Yasin, Karalok, Alper, Duru Çöteli, Sinem Ayşe, Boran, Nurettin, Ünsal, Mehmet, Boyraz, Gökhan, Turan, Taner
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Galenos Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731606/
https://www.ncbi.nlm.nih.gov/pubmed/33343976
http://dx.doi.org/10.4274/tjod.galenos.2020.54781
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author Durmuş, Yasin
Karalok, Alper
Duru Çöteli, Sinem Ayşe
Boran, Nurettin
Ünsal, Mehmet
Boyraz, Gökhan
Turan, Taner
author_facet Durmuş, Yasin
Karalok, Alper
Duru Çöteli, Sinem Ayşe
Boran, Nurettin
Ünsal, Mehmet
Boyraz, Gökhan
Turan, Taner
author_sort Durmuş, Yasin
collection PubMed
description OBJECTIVE: To evaluate pulmonary morbidity related to diaphragm surgery performed for gynecological cancers and to identify the impact of transdiaphragmatic thoracotomy. MATERIALS AND METHODS: We reviewed clinical and pathologic data of 232 women who had undergone diaphragm surgery as a part of cytoreductive surgery procedures performed for gynecological cancers. RESULTS: Transdiaphragmatic thoracotomy occurred in 52 patients (22.4%). Rate of pulmonary complications among patients who had a transdiaphragmatic thoracotomy was higher compared with patients who did not have a transdiaphragmatic thoracotomy (40.4% vs 20.6%, p=0.004). Transdiaphragmatic thoracotomy [odds ratio (OR), 2.66; 95% confidence interval (CI), 1.20-5.92; p=0.016], colon resection (OR, 5.21; 95% CI, 2.34-11.63; p<0.001), ileostomy (OR, 19.61; 95% CI, 1.64-250.0; p=0.019), and any extra-pulmonary complication occurrence (OR, 2.35; 95% CI, 1.13-4.88; p=0.023) were identified as independent predictors of pulmonary morbidity. Patients with transdiaphragmatic thoracotomy developed pleural effusion, pleural effusion necessitating drainage, pneumothorax, pneumonitis, and atelectasis more frequently compared with patients who did not have transdiaphragmatic thoracotomy. Rate of admission to postoperative intensive care of patients with transdiaphragmatic thoracotomy (30.8%) was significantly higher than that of patients without transdiaphragmatic thoracotomy (12.2%) (p=0.001). CONCLUSION: Transdiaphragmatic thoracotomy is an independent predictor of pulmonary morbidity among patients who underwent diaphragm surgery. Avoiding accidental transdiaphragmatic thoracotomies with maximal attention and performing full-thickness resection procedures with alternative surgical techniques preventing a thoracotomy may help decrease pulmonary morbidity rates and postoperative care costs.
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spelling pubmed-77316062020-12-18 Pulmonary morbidity related to diaphragm surgery performed for gynecological cancers Durmuş, Yasin Karalok, Alper Duru Çöteli, Sinem Ayşe Boran, Nurettin Ünsal, Mehmet Boyraz, Gökhan Turan, Taner Turk J Obstet Gynecol Clinical Investigation OBJECTIVE: To evaluate pulmonary morbidity related to diaphragm surgery performed for gynecological cancers and to identify the impact of transdiaphragmatic thoracotomy. MATERIALS AND METHODS: We reviewed clinical and pathologic data of 232 women who had undergone diaphragm surgery as a part of cytoreductive surgery procedures performed for gynecological cancers. RESULTS: Transdiaphragmatic thoracotomy occurred in 52 patients (22.4%). Rate of pulmonary complications among patients who had a transdiaphragmatic thoracotomy was higher compared with patients who did not have a transdiaphragmatic thoracotomy (40.4% vs 20.6%, p=0.004). Transdiaphragmatic thoracotomy [odds ratio (OR), 2.66; 95% confidence interval (CI), 1.20-5.92; p=0.016], colon resection (OR, 5.21; 95% CI, 2.34-11.63; p<0.001), ileostomy (OR, 19.61; 95% CI, 1.64-250.0; p=0.019), and any extra-pulmonary complication occurrence (OR, 2.35; 95% CI, 1.13-4.88; p=0.023) were identified as independent predictors of pulmonary morbidity. Patients with transdiaphragmatic thoracotomy developed pleural effusion, pleural effusion necessitating drainage, pneumothorax, pneumonitis, and atelectasis more frequently compared with patients who did not have transdiaphragmatic thoracotomy. Rate of admission to postoperative intensive care of patients with transdiaphragmatic thoracotomy (30.8%) was significantly higher than that of patients without transdiaphragmatic thoracotomy (12.2%) (p=0.001). CONCLUSION: Transdiaphragmatic thoracotomy is an independent predictor of pulmonary morbidity among patients who underwent diaphragm surgery. Avoiding accidental transdiaphragmatic thoracotomies with maximal attention and performing full-thickness resection procedures with alternative surgical techniques preventing a thoracotomy may help decrease pulmonary morbidity rates and postoperative care costs. Galenos Publishing 2020-12 2020-12-10 /pmc/articles/PMC7731606/ /pubmed/33343976 http://dx.doi.org/10.4274/tjod.galenos.2020.54781 Text en ©Copyright 2020 by Turkish Society of Obstetrics and Gynecology | Turkish Journal of Obstetrics and Gynecology published by Galenos Publishing House. http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Investigation
Durmuş, Yasin
Karalok, Alper
Duru Çöteli, Sinem Ayşe
Boran, Nurettin
Ünsal, Mehmet
Boyraz, Gökhan
Turan, Taner
Pulmonary morbidity related to diaphragm surgery performed for gynecological cancers
title Pulmonary morbidity related to diaphragm surgery performed for gynecological cancers
title_full Pulmonary morbidity related to diaphragm surgery performed for gynecological cancers
title_fullStr Pulmonary morbidity related to diaphragm surgery performed for gynecological cancers
title_full_unstemmed Pulmonary morbidity related to diaphragm surgery performed for gynecological cancers
title_short Pulmonary morbidity related to diaphragm surgery performed for gynecological cancers
title_sort pulmonary morbidity related to diaphragm surgery performed for gynecological cancers
topic Clinical Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731606/
https://www.ncbi.nlm.nih.gov/pubmed/33343976
http://dx.doi.org/10.4274/tjod.galenos.2020.54781
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