Our Summary

This research paper looks at how effective a certain treatment is for patients who have a buildup of blood clots in the space around their lungs after having lung surgery. The treatment involves injecting a substance called urokinase into that space to dissolve the clots.

In the study, 46 patients who had lung surgery and then developed these clots were given this treatment. The researchers then checked to see how many of these patients got better and how many didn’t. They also looked at whether the treatment caused any bad side effects.

The results were promising. Out of the 46 patients, the treatment worked for 42 of them (91.3%). Thirty-five of these patients (76.1%) completely got rid of the clots, while seven (15.2%) still had a small amount left, but not enough to cause problems. These 42 patients didn’t need any more intervention for fluid buildup around their lungs. However, the treatment didn’t work for four patients (8.7%). One patient developed a bronchopleural fistula (a hole between the bronchus and the space around the lungs), but it healed by itself. The other three patients needed another procedure to drain the fluid around their lungs.

The researchers didn’t observe any serious side effects from the treatment, like bleeding or allergic reactions. Therefore, they concluded that this treatment should be considered a good option for patients who develop blood clots around their lungs after lung surgery. It appears to be safe and effective for over 90% of these patients.

FAQs

  1. What is the purpose of intrapleural fibrinolytic therapy with urokinase in treating residual coagulated hemothorax after lung surgery?
  2. What were the results of the study on the use of intrapleural urokinase for residual hemothorax after lung surgery?
  3. Are there any serious adverse events or complications associated with the administration of intrapleural urokinase?

Doctor’s Tip

A doctor may advise a patient undergoing lung surgery that intrapleural fibrinolytic therapy with urokinase can be a useful treatment option for residual coagulated hemothorax after surgery. This treatment has shown to be successful in over 90% of patients, with minimal risk of serious adverse events. It is important to follow up with your healthcare provider and adhere to their recommendations for monitoring and management after surgery.

Suitable For

Patients who are typically recommended for lung surgery include those with lung cancer, advanced emphysema, severe chronic obstructive pulmonary disease (COPD), lung infections such as tuberculosis or fungal infections, lung nodules, or other lung diseases that have not responded to other treatments. Additionally, patients who have experienced traumatic injuries to the chest or lungs may also require lung surgery.

Timeline

Before lung surgery:

  1. Consultation and evaluation by a pulmonologist or thoracic surgeon
  2. Preoperative testing such as chest X-ray, CT scan, pulmonary function tests
  3. Discussion of surgical options, risks, and benefits with the patient
  4. Consent for surgery signed by the patient
  5. Preoperative preparations such as fasting, medication adjustments, and possible hospital admission

After lung surgery:

  1. Initial recovery period in the hospital with close monitoring by medical staff
  2. Pain management, breathing exercises, and physical therapy to aid in recovery
  3. Chest X-ray or CT scan to assess the surgical site and monitor for complications
  4. Drainage of any blood or fluid accumulation in the pleural cavity
  5. Possible administration of intrapleural fibrinolytic therapy with urokinase for residual hemothorax
  6. Follow-up appointments with the surgeon for monitoring progress and addressing any concerns
  7. Gradual return to normal activities and lifestyle with ongoing follow-up care as needed.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lung surgery and intrapleural fibrinolytic therapy for hemothorax include:

  1. What is the purpose of intrapleural fibrinolytic therapy with urokinase for residual coagulated hemothorax after lung surgery?
  2. How is the procedure performed and what can I expect during and after the treatment?
  3. What are the potential risks and complications associated with intrapleural urokinase administration?
  4. What is the success rate of this treatment for postoperative hemothorax?
  5. Will I need any follow-up procedures or interventions after receiving intrapleural fibrinolytic therapy?
  6. Are there any alternative treatments or medications available for residual hemothorax after lung surgery?
  7. How long will it take for me to recover from the treatment and resume normal activities?
  8. What are the signs and symptoms I should watch out for that may indicate a complication or the need for further medical attention?
  9. Are there any lifestyle changes or precautions I should take after receiving intrapleural fibrinolytic therapy for hemothorax?
  10. Can you provide me with more information or resources about this treatment option and its effectiveness in treating postoperative hemothorax?

Reference

Authors: Huang D, Zhao D, Zhou Y, Liu H, Chen X. Journal: World J Surg. 2016 May;40(5):1121-8. doi: 10.1007/s00268-015-3378-9. PMID: 26711639