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My Mother After Ovarian Cancer Stage IIIC Surgery (Cyto Reduction

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Posted on Tue, 23 Apr 2019
Question: My mother after ovarian cancer stage IIIC surgery (Cyto reduction (Diagnostic laparoscopy-staging laparotomy+TAH+BSO+Pelvic peritonectomy+Segmental traverse colectomy Bilateral sub diaphragmatic peritonectomy).
i) She is feeling intermittently breathing problem and still in ICU approx . At the time of breathing problem SPO2 level is decreasing. If oxygen given for sometime through pipe she is feeling OK. Spirometer test she is doing upt 300 only. Is it be improved?
II) Three days back she developed pneumothorax on right lung doctors added pipe to lung to remove liquid or air from it. daily 200ml liquid is coming in lungs.

Is the situation critical or chances are there that liquid is reduced and lungs can function again.
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Follow up: Dr. Drkaushal85 (0 minute later)
My mother after ovarian cancer stage IIIC surgery (Cyto reduction (Diagnostic laparoscopy-staging laparotomy+TAH+BSO+Pelvic peritonectomy+Segmental traverse colectomy Bilateral sub diaphragmatic peritonectomy).
i) She is feeling intermittently breathing problem and still in ICU approx . At the time of breathing problem SPO2 level is decreasing. If oxygen given for sometime through pipe she is feeling OK. Spirometer test she is doing upt 300 only. Is it be improved?
II) Three days back she developed pneumothorax on right lung doctors added pipe to lung to remove liquid or air from it. daily 200ml liquid is coming in lungs.

Is the situation critical or chances are there that liquid is reduced and lungs can function again.
doctor
Answered by Dr. Drkaushal85 (2 hours later)
Brief Answer:
Possibility of malignant effusion is more likely.

Detailed Answer:
Thanks for your question on Ask a doctor forum.
I can understand your concern.
I have gone through the history you have given.
Possibility of malignant effusion is more likely.
This condition is not easy to treat.
If effusion is simple (non malignant), then she will definitely improve.
But if effusion is malignant, then chances of oxygen saturation improvement is very less.
She might need permanent drainage tube for pleural effusion.
Can you please tell me
1. Is CT thorax done?
2. What is cytology report of pleural fluid?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Drkaushal85 (0 minute later)
Brief Answer:
Possibility of malignant effusion is more likely.

Detailed Answer:
Thanks for your question on Ask a doctor forum.
I can understand your concern.
I have gone through the history you have given.
Possibility of malignant effusion is more likely.
This condition is not easy to treat.
If effusion is simple (non malignant), then she will definitely improve.
But if effusion is malignant, then chances of oxygen saturation improvement is very less.
She might need permanent drainage tube for pleural effusion.
Can you please tell me
1. Is CT thorax done?
2. What is cytology report of pleural fluid?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Drkaushal85 (2 days later)
Dear Sir

Thanks for the reply, pls find the CT scan findings
i) No evidence of acute or chronic pulmonary thromboembolism
ii)Minimal right pneumothorax
Bilateral mild pleural effusion (R>L) with segmental consolidation & passive collapse in bilateral lower lobes.

Now the issue and status is the inserted chest tube is not getting liquid but in some other portion near lung liquid formed which today removed using injection & sent for cytology report. Doctors are not confirming the re-occurance of liquid. What is the better possible solution if this liquid is forming like this we cannot go to home, we don't know exact time this liquids will reduce to stay in hospital. Is there any chance that liquid is reduced.
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Follow up: Dr. Drkaushal85 (0 minute later)
Dear Sir

Thanks for the reply, pls find the CT scan findings
i) No evidence of acute or chronic pulmonary thromboembolism
ii)Minimal right pneumothorax
Bilateral mild pleural effusion (R>L) with segmental consolidation & passive collapse in bilateral lower lobes.

Now the issue and status is the inserted chest tube is not getting liquid but in some other portion near lung liquid formed which today removed using injection & sent for cytology report. Doctors are not confirming the re-occurance of liquid. What is the better possible solution if this liquid is forming like this we cannot go to home, we don't know exact time this liquids will reduce to stay in hospital. Is there any chance that liquid is reduced.
doctor
Answered by Dr. Drkaushal85 (1 hour later)
Brief Answer:
This doubt will clear after cytology report.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
Your doubt will clear after cytology report.
If cytology is positive for malignant cells then possibility of recurrent effusion is more.
If cytology is negative then gradually fluid will reduce but it will take around 3-4 weeks at least.
I will be happy to help you further. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Drkaushal85 (0 minute later)
Brief Answer:
This doubt will clear after cytology report.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
Your doubt will clear after cytology report.
If cytology is positive for malignant cells then possibility of recurrent effusion is more.
If cytology is negative then gradually fluid will reduce but it will take around 3-4 weeks at least.
I will be happy to help you further. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Drkaushal85 (6 days later)
Dear Sir,

Doctors confirmed there is no issue on malignancy side, no infection. they did thoracoscopy for the patient to Right lung and inserted two drains but it is observed that full liquip is not draining to the tubes some liquid is still remaining in the lung. They are removing with needle. What are the alternatives to manage the situation? Like if we take home two days once can we take the patient for removal of liquid to feel better.

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Follow up: Dr. Drkaushal85 (0 minute later)
Dear Sir,

Doctors confirmed there is no issue on malignancy side, no infection. they did thoracoscopy for the patient to Right lung and inserted two drains but it is observed that full liquip is not draining to the tubes some liquid is still remaining in the lung. They are removing with needle. What are the alternatives to manage the situation? Like if we take home two days once can we take the patient for removal of liquid to feel better.

doctor
Answered by Dr. Drkaushal85 (7 hours later)
Brief Answer:
Yes, you can take her home.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
It's good that it is not malignant effusion.
And yes, you can definitely take her home with drains.
What are the reports of fluid?
Is it bacterial?
Is it tuberculosis?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Drkaushal85 (0 minute later)
Brief Answer:
Yes, you can take her home.

Detailed Answer:
Thanks for your follow up question on Ask a doctor forum.
I can understand your concern.
It's good that it is not malignant effusion.
And yes, you can definitely take her home with drains.
What are the reports of fluid?
Is it bacterial?
Is it tuberculosis?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
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Dr. Drkaushal85

Pulmonologist

Practicing since :2008

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My Mother After Ovarian Cancer Stage IIIC Surgery (Cyto Reduction

My mother after ovarian cancer stage IIIC surgery (Cyto reduction (Diagnostic laparoscopy-staging laparotomy+TAH+BSO+Pelvic peritonectomy+Segmental traverse colectomy Bilateral sub diaphragmatic peritonectomy). i) She is feeling intermittently breathing problem and still in ICU approx . At the time of breathing problem SPO2 level is decreasing. If oxygen given for sometime through pipe she is feeling OK. Spirometer test she is doing upt 300 only. Is it be improved? II) Three days back she developed pneumothorax on right lung doctors added pipe to lung to remove liquid or air from it. daily 200ml liquid is coming in lungs. Is the situation critical or chances are there that liquid is reduced and lungs can function again.