Effect of early administration of tolvaptan on pleural effusion post-hepatectomy

Abstract

Abstract Purpose: In this study, the efficacy of tolvaptan administration at the early stage post-hepatectomy was evaluated to control pleural effusion and improve the postoperative course. Methods: Patients were administered tolvaptan (7.5 mg) and spironolactone (25 mg) from postoperative day 1 to 5 (tolvaptan group, n=68) for 13 months. Early administration of tolvaptan was not given in the control group (n=68) but diuretics were appropriately administered according to the patient's condition. The amount of pleural effusion on computed tomography on postoperative day 5 was compared between the two groups. Results: The amount of pleural effusion and increase in body weight on postoperative day 5 showed significant differences in both groups (p<0.001 and p=0.019, respectively). However, the rate of pleural aspiration and the duration of postoperative hospitalization did not show any significant differences. The amount of intraoperative blood loss and lack of early administration of tolvaptan were identified as independent risk factors contributing to pleural effusionon multivariate analysis. Conclusion: Early administration of tolvaptan to post-hepatectomy patients was found to be capable of controlling postoperative pleural effusion and increase in body weight, but it did not reduce the rate of pleural aspiration or the hospitalization period.