Evaluation of the surgical fat-filling procedure in the treatment of refractory cough after systematic mediastinal lymphadenectomy in patients with right lung cancer

J Surg Res. 2014 Apr;187(2):490-5. doi: 10.1016/j.jss.2013.10.062. Epub 2013 Nov 5.

Abstract

Background: To evaluate the efficacy of the surgical fat-filling procedure (SFFP) in the treatment of refractory cough and quality of life (QOL) after systematic mediastinal lymphadenectomy in patients with right lung cancer.

Methods: This is a blinded, randomized, controlled clinical trial to evaluate refractory cough and QOL in patients after mediastinal lymphadenectomy for lung cancer. One hundred eligible lung cancer patients were randomly divided into two groups: the fat-filling group and non-filling group. In the fat-filling group, post-lymphadenectomy residual cavities (PLRCs) were filled with fatty tissue autografts after lymph node dissection. In the non-filling group, the PLRCs remained unfilled. Clinical endpoints were postoperative cough score and QOL.

Results: The SFFP did not increase intraoperative bleeding, extend operation time, or hospital stay. Further, night cough was significantly improved after 4 wk in the fat-filling group after the removal of a chest drainage tube. QOL issues, such as emotional condition, functional status, and additional concerns, demonstrated a remarkable improvement in the fat-filling group at postoperative 1 mo compared with the non-filling (control) group.

Conclusions: This study demonstrates that filling PLRCs with fatty tissue autografts is a safe and partially effective treatment for refractory cough after major pulmonary resection and mediastinal lymphadenectomy. This novel procedure significantly improved patient QOL and may prove useful as a relatively safe preventive surgical adjunct operation for refractory cough.

Keywords: Lung cancer; Mediastinal lymphadenectomy; Quality of life; Refractory cough; Surgical fat-filling procedure.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adipose Tissue / transplantation*
  • Aged
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Cough / etiology
  • Cough / surgery*
  • Female
  • Humans
  • Lung Neoplasms / surgery*
  • Lymph Node Excision / adverse effects*
  • Lymph Node Excision / methods
  • Male
  • Mediastinum / surgery
  • Middle Aged
  • Pneumonectomy / methods
  • Prospective Studies
  • Quality of Life
  • Single-Blind Method
  • Transplantation, Autologous
  • Treatment Outcome