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Thorac Cardiovasc Surg 2004; 52(4): 191-195
DOI: 10.1055/s-2004-820869
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Minimally Invasive Thoracic Surgery for Diagnostic Assessment and Palliative Treatment in Recurrent Neoplastic Pleural Effusion[*]

P. P. Brega-Massone1 , B. Conti1 , B. Magnani2 , F. Ferro3 , C. Lequaglie1
  • 1Oncologic Thoracic Surgery, National Cancer Institute, Milan, Italy
  • 2Statistical Unit, II. AA. RR., Pavia, Italy
  • 3General Surgery, Civil Hospital, Voghera, Italy
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Publikationsverlauf

Received February 27, 2003

Publikationsdatum:
04. August 2004 (online)

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Abstract

Background: We evaluated the effectiveness of VATS in the diagnosis and palliative treatment of recurrent neoplastic pleural effusions. Methods: From 1987 to 2001, we performed 325 VATS chemical pleurodesis for malignant pleural effusions. We used talc in 253 subjects (78 %) and alcohol in 72 (22 %) as the sclerosant agent. In 226 patients (68 %) we performed biopsies because the histology was unknown. Results: Mean operating time was 33.38 ± 9.77 minutes (median: 32; range: 19 - 58), and the mean duration of chest intubation was 3.78 ± 1.33 days (median: 4; range 2 - 8). Complications occurred in 2 % of patients. Thirty-day mortality was 2 %. Mean postoperative inhospital stay was 5.53 ± 1.90 days (median 6; range: 2 - 11). We obtained 264 (81 %) therapeutic successes (no effusion recurrence within 4 months), and 55 relapses of which 32 had talc insufflation (13 % of talc group) and 23 alcohol instillation (32 % of alcohol group). Conclusions: VATS chemical pleurodesis is a safe, useful, versatile procedure for oncological pleural effusion management. The use of talc rather than alcohol significantly increased the therapeutic success rate. VATS should be considered the treatment of choice in patients with advanced neoplasm to obtain good palliation and a better quality of life.

Key words

Neoplastic pleural effusion - diagnostic assessment - palliative treatment - pleurodesis - video-assisted thoracoscopic surgery (VATS)

1 The abstract was selected and presented at the EACTS/ESTS Joint Meeting 2001. Lisbon (Portugal), September 16 - 19, 2001

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1 The abstract was selected and presented at the EACTS/ESTS Joint Meeting 2001. Lisbon (Portugal), September 16 - 19, 2001

Dr. P. P. Brega-Massone

Oncologic Thoracic Surgery · National Cancer Institute Milan

Via Cascina Spelta, 24/b

27100 Pavia

Italy

Telefon: + 39(02)23902384

Fax: + 39 (02) 2 36 04 86

eMail: ppbm@virgilio.it

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