Effects of suturing of the mediastinal pleura on lessening pleural effusions after lobectomy in patients with non-small cell lung cancer.

BACKGROUND

Lobectomy in patients with non-small cell lung cancer (NSCLC) results in empty spaces filled up with gases and superfluous pleural effusions. This study aimed to evaluate the effects of suturing of the mediastinal pleura (SMP) on reducing pleural effusion after lobectomy.

METHODS

Medical records of 529 patients with NSCLC who underwent right lung lobectomy and systematic mediastinal lymph node dissection (SMLD) were retrospectively reviewed, including 131 who underwent SMP and 324 in the control group. SMP surgery was performed to suture the mediastinal pleura of the azygos arch using a continuous barbed wire suturing along the anatomical boundary of the mediastinal lymph node dissection. A chest tube was placed, and pleural fluid was measured daily after surgery. Multivariate linear regression analyses were used to compare drainage volume.

RESULTS

The SMP group showed significantly decreased total drainage volume (P<0.0001), plasma albumin loss (P<0.001), and shorter duration of chest tube (P<0.0001) compared to the control group. Multivariate linear regression analyses confirmed significantly less pleural drainage volume, reduced plasma albumin loss, and shorter duration of chest tube placement in patients with SMP. Lobectomy at different sites had minimal effects on drainage volume or chest tube duration.

CONCLUSIONS

SMP in NSCLC patients following SMLD significantly reduced pleural effusion, plasma albumin loss, and chest tube duration, indicating that SMP has benefits for the recovery of right lung lobectomy.