Abstract
BackgroundMalignant pleural effusion is a common sequelae in patients with certain malignancies. It represents a terminal condition with short median survival (in terms of months) and the goal is palliation. Aim of our study is to analyze morbidity, mortality and life expectancy following videothoracoscopic talc poudrage.Materials and methodsFrom September 2004 to October 2009, 400 patients underwent video-assisted thoracic surgery (VATS) for malignant pleural effusion. The conditions of patients were assessed and graded before and after treatment concerning morbidity, mortality, success rate of pleurodesis and median survival.ResultsThe median duration of follow up was 40 months (range 4-61 months). All patients demonstrated notable improvement in dyspnea. Intraoperative mortality was zero. The procedure was well tolerated and no significant adverse effects were observed. In hospital mortality was 2% and the pleurodesis success rate was 85%. A poor Karnofsky Performance Status and delay between diagnosis of pleural effusion and pleurodesis were statistically significant factors for in-hospital mortality. The best survival was seen in breast cancer, followed by ovarian cancer, lymphoma and pleural mesothelioma.ConclusionsVideo-assisted thoracoscopic talc poudrage is an effective and safe procedure that yields a high rate of successful pleurodesis and achieves long-term control with marked dyspnea decrease.
Highlights
Pleural effusions are a common and devastating complication of advancedmalignancies
The best survival was seen in breast cancer, followed by ovarian cancer, lymphoma and pleural mesothelioma
Video-assisted thoracoscopic talc poudrage is an effective and safe procedure that yields a high rate of successful pleurodesis and achieves long-term control with marked dyspnea decrease
Summary
Pleural effusions are a common and devastating complication of advancedmalignancies. These effusions most commonly occur with lung, breast, ovarian cancer and lymphoma, with breast and lung malignancies alone accounting for approximately of 75% of these effusions [1].In patients who develop progressive pleural effusions producing dyspnea and cough, quality of life is affected. Pleural effusions are a common and devastating complication of advancedmalignancies. These effusions most commonly occur with lung, breast, ovarian cancer and lymphoma, with breast and lung malignancies alone accounting for approximately of 75% of these effusions [1]. In patients who develop progressive pleural effusions producing dyspnea and cough, quality of life is affected. The purpose of this study was to determine the long term efficacy and safety of pleurodesis by thoracoscopic talc poudrage in malignant pleural effusions. Malignant pleural effusion is a common sequelae in patients with certain malignancies. It represents a terminal condition with short median survival (in terms of months) and the goal is palliation. Aim of our study is to analyze morbidity, mortality and life expectancy following videothoracoscopic talc poudrage
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