Malign plevral efüzyonlarda tek port torakoskopik talk plöredez

Abstract

Aim The aim of this study was to evaluate the efficacy of single-incision thoracoscopic surgery (SITS) talc pleurodesis for malignant pleural effusion.Material and Methods We examined the medical records of all consecutive patients with malignant pleural effusion who underwent single port thoracoscopic pleurodesis from 2014 to 2018 at the Health Sciences University Antalya Practice and Research Center. There were 30 males (54.5%) and 25 females (45.4%), ranging in age from 35 to 88 years (mean age: 64.0 years). Pleurodesis was achieved by insufflation of 4g of sterile asbestos-free talc; the chest tube was left in place a minimum of 3 days and was removed when fluid drainage was less than 100 ml/24 h. Patients were discharged the day after chest tube removal and a return visit was scheduled on the 30th post-operative day, for clinical evaluation and for a new chest radiograph. Pleurodesis was regarded as successful if the amount of the fluid on chest radiograph on the 30th post-operative day showed a pleural effusion occupying less than one-fourth of the pleural space.Results The main causes of malignant pleural effusion were non-small cell lung carcinoma and breast cancer. Major symptoms were dyspnea, chest pain and radiographic findings of pleural fluid. The effusion was on the right side in 40 patients (72.7%) and on the left side in 15 (27.2%). There was no intraoperative mortality. The postoperative complication rate was 10.9% (6 patients), and included fever in 1.8% (one patient) and chest pain in 9.0% (5 patients) of the patients. Duration of postoperative pleural drainage ranged between 3 and 13 days (mean: 3.36 days). The postoperative hospital stay ranged from 3 to 15 days (mean: 5.6 days). A successful pleurodesis was achieved in 34 of 55 patients (61.8%). Conclusion SITS talc pleurodesis is an effective and safe treatment for the management of malignant pleural effusion.