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KMID : 0364020070400070492
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Korean Journal of Thoracic and Cardiovascular Surgery
2007 Volume.40 No. 7 p.492 ~ p.498
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Video-assisted Talc Poudrage for the Treatment of Malignant Pleural Effusion: Analysis of Effects and Benefits
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Song In-Hak
Kim Hyun-Jo
Jang Won-Ho
Choi Chang-Woo
Son Jin-Sung
Kim Dong-Hyun
Baek Kang-Seok
Youm Wook
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Abstract
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Background:Malignant pleural effusion is a common condition in neoplastic patients and palliative therapy is the usual treatment. Talc has been generally accepted to be the most effective sclerosant for chemical pleurodesis, but the optimal route of administration remains controversy. We compared the results of video-assisted thoracoscopic talc poudrage (VTP) with administering a bedside talc slurry through a chest tube (BTS) for the treatment of malignant pleural effusion.
Material and Method:From December 2004 to May 2006, 20 patients with malignant pleural effusion underwent chemical pleurodesis via VTP (group A, n=10), and BTS (group B, n=10).
Result:The durations of chest tube placement after the procedure were 7.0±4.0 days (group A) and 6.7±3.6 days (group B). The hospital stays were 24.3±9.4 days (group A) and 30.7±21.5 days (group B), respectively. The symptoms of dyspnea were much more improved in group A (p-value=0.014) after discharge (mean f/u group A=8.5±2.2 months, group B 8.0±7.4 months). The collapsed portions of lung were better expanded in group A than in group B (p-value= 0.011).
Conclusion:We recommend VTP for the selected patients with malignant pleural effusion because of the advantages of dissecting the fibrous peel to relieve the atelectasis and dyspnea, and excising the pleura for diagnosis with direct viewing of the lesion.
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KEYWORD
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Pleural effusion, Talc, Pleurodesis, Thoracoscopy
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