Retrospective case-control study on the outcomes of early minimally invasive pleural lavage for pleural empyema in oncology patients.

BACKGROUND

Oncology patients carry a substantial risk of developing pleural empyema. Here, we report the preliminary results of our early video-assisted thoracoscopic surgery (VATS) lavage strategy in cases of empyema occurring in patients undergoing (radio-) chemotherapy.

METHODS

This was a retrospective case-control study comparing early VATS lavage (test group, current therapy since January 2018, n = 46) versus VATS pleurectomy (historical control; before January 2018, n = 46).

RESULTS

Five patients in the control group and one in the test group developed recurrence of empyema within 30 days. Complications were more severe and more frequently observed in the historical control group than in the test group (30/46 vs. 12/46 CI: 5%-95%, p = < 0.05). Early VATS lavage saved operating time, allowed a shorter ICU stay (2.6 days CI: 5%-95% vs. 5.1 days CI: 5%-95%, p = ns) and an earlier hospital discharge (6.1 days CI: 5%-95% vs. 13.5 days CI: 5%-95%, p < 0.05). Moreover, radio and/or chemotherapy could be reinitiated earlier (15 ± 20.5 days CI: 5%-95% vs. 40 ± 12 days CI: 5%-95%, p < 0.05).

CONCLUSIONS

In this retrospective cohort study, early VATS lavage was found to have a beneficial effect especially on hospital stay and enabling an earlier restart of radio- and/or chemotherapy.