Abstract
Objective: In 2013 we started to combine VATS poudrage with simultaneous insertion of an indwelling pleural catheter (IPC) for management of malignant pleural effusions (MPE) to achieve successful pleurodesis, avoid recurrence of MPE and shorten hospitalization time. The aim of this study was to distinguish whether the combination treatment is superior over standard VATS poudrage. Methods: This retrospective descriptive study analyses data of patients with MPE treated at our department since the implementation of the method. The historic control group included patients with MPE treated with VATS poudrage alone. Results: There were 117 patients, 67 patients were treated with the new approach (IPC group) and 50 patients with VATS talc poudrage (control group). Both groups were comparable in demographic data. The postoperative hospitalization time was significantly shorter in the IPC group (P=0.0001). Patients in the control group got 2 chest drains inserted (Ch 24/Ch 28) and in the IPC group 1 chest drain (Ch 24) plus the IPC. Chest drains could be removed quicker in the IPC group (P=<0.0001). So far there was not a single case of unsuccessful pleurodesis with our approach compared to 10% failure rate in the control group. Conclusion: The combined approach is a safe and effective approach in MPE prophylaxis. Patients were discharged earlier and further treatment, e.g., chemotherapy, could be initiated in time.
Highlights
Introduction over a longer period than in the normal VATS talcage procedure
The insertion of an indwelling pleural catheter (IPC) can reduce the hospitalization time in case of malignant pleural effusion since they can be inserted as an outpatient procedure [8]. In this retrospective analysis we report our experience with the VATS talc pleurodesis and the concomitant insertion of IPC in comparison to VATS talcs pleurodesis only
Since February 2013 VATS poudrage with simultaneous insertion of an IPC has been routinely performed for treatment of malignant pleural effusion at the Division of General Thoracic Surgery, Bern University Hospital, Switzerland
Summary
This retrospective descriptive study analyses data of patients with MPE treated at our department since the implementation of the method. The historic control group included patients with MPE treated with VATS poudrage alone. Since February 2013 VATS poudrage with simultaneous insertion of an IPC has been routinely performed for treatment of malignant pleural effusion at the Division of General Thoracic Surgery, Bern University Hospital, Switzerland. All patients undergoing this surgical procedure were registered in this retrospective trial until the end of May 2015 (16 months). P-values were calculated using the Mann Whitney U test. P-values of less than 0.05 were considered statistically significant
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