F-073THE EFFECT OF COLCHICINE ADMINISTRATION ON POSTOPERATIVE PLEURAL EFFUSION FOLLOWING THORACIC SURGERY: A RANDOMIZED, DOUBLE BLIND, PLACEBO-CONTROLLED, FEASIBILITY PILOT STUDY

Abstract

Objectives: Colchicine was previously found to be effective in preventing postoperative pericardial effusion following cardiac surgery with potent antiinflammatory effects. This study seeks to assess its effect on the volume of postoperative pleural drainage, duration of chest tube in‐situ and length of stay following lung resection. Methods: Between April 2014 and April 2015, 100 patients undergoing lung resection at two tertiary care centres were randomized to either colchicine (n = 49) or placebo (n = 51) treatment arms), as part of a feasibility, pilot double‐blind study assessing colchicine for prevention of perioperative atrial fibrillation. Patients received either colchicine 0.6 mg or placebo orally twice daily for 10 days, with the first dose given 4 hours prior to surgery. Pleural drainage volumes were recorded in 8‐hour intervals until chest tube removal as per a standardized, pre‐defined protocol. Results: The two groups were comparable on baseline characteristics with regard to cancer stage, comorbidities, surgical approach and extent of resection (51% open procedures; 86% anatomic resections), but not for gender, coronary artery disease and hypertension. Analysis of total drainage volumes demonstrated a statistically significant difference in favour of the colchicine group (583.8 vs 763.3 ml, P = 0.039), with findings that remained consistent across the time intervals collected. The volume of pleural drainage at 1‐hour postop was significantly less in the colchicine group (92.9 vs 156.6 ml, P = 0.008), and remained lower at the 40‐hour interval (550.9 vs 741.3 ml, P = 0.039). There were no differences in time to chest tube removal (6.8 vs 5.9 days, P = 0.585), hospital length of stay (7.4 vs 6.9 days, P = 0.641), or with regards to major bleeding, infection or adverse events. Conclusion: Perioperative administration of oral colchicine is potentially effective in diminishing the amount of pleural drainage post‐lung resection. A full‐scale, prospective placebo‐control randomized trial is needed to assess the clinical significance of perioperative colchicine administration.