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The Annals of Thoracic Surgery, Vol 51, 599-604, Copyright © 1991 by The Society of Thoracic Surgeons
M Okumura, S Ohshima, Y Kotake, H Morino, M Kikui and T Yasumitsu
Cytology of intraoperative pleural lavage was examined in 164 lung cancer
patients who underwent pulmonary resections. None of the patients had any
pleural effusion or dissemination. Cytology was performed three times: (1)
at thoracotomy, (2) immediately after resection, and (3) after washing the
pleural cavity with 5,000 mL of physiological saline solution just before
closure of the chest wall. Twenty-three patients (14%) had more than one
positive cytological finding. The frequency of positive cytological
findings was significantly correlated with pathological T classification,
pleural status, and pathological stage. The positive lavage group had a
significantly higher recurrence rate than the negative lavage group in
patients with stage I or stage II cancer. Four patients in the positive
lavage group (17.4%) had recurrence in pleura or pericardium whereas only 1
patient in the negative lavage group (0.7%) had a recurrence in
pericardium. The positive cytological finding of pleural lavage has more
important meaning as a prognostic factor in stage I and stage II and
indicates a greater possibility of recurrence in pleura or pericardium, but
further examinations to evaluate the viability of detected malignant cells
are required so that the positive cytological findings of pleural lavage
can be regarded as subclinical pleural dissemination.
ARTICLES
Intraoperative pleural lavage cytology in lung cancer patients
Department of Surgery, Osaka Prefectural Habikino Hospital, Japan.
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