Open AccessMALIGNANT PLEURAL EFFUSION
Author(s) -
Muhammad Imran Hameed Daula
Publication year - 2015
Publication title -
the professional medical journal/the professional medical journal
Language(s) - English
Resource type - Journals
eISSN - 2071-7733
pISSN - 1024-8919
DOI - 10.29309/tpmj/2015.22.06.1257
Subject(s) - medicine , pleurodesis , malignant pleural effusion , surgery , chest tube , empyema , pleural effusion , talc , thoracoscopy , pneumothorax , materials science , composite material
Objectives: To assess the role of video assisted thoracoscopic talc pleurodesisin the surgical management of malignant pleural effusions by comparing this procedure withpleurodesis via talc slurry through an intercostals chest tube. Design: Prospective analysisof fifty patients with malignant pleural effusion which were divided into two groups. Groupone included twenty patients while group two included thirty patients. Setting: Department ofThoracic Surgery and the Department of Oncology, Combined Military Hospital, Rawalpindi.Period: October 2008 till November 2010. Subjects: Fifty patients of malignant pleural effusionwere included in the study. They were divided into two groups. Group one included twentypatients whereas group two included thirty patients. Interventions: Patients in group onewere subjected to videoassisted thoracoscopic talc pleurodesis. Patients in group two weresubjected to pleurodesis via talc slurry through an intercostal drainage tube. RESULTS: Fiftypatients were included in the study. The mean follow up time was 5.7 months for group oneand 5.5 months for group two. Out of the twenty patients in group one 95% had successfulpleurodesis (defined as satisfactory pleurodesis three months post procedure). Adverse effectsincluded fever in three patients (15%), empyema in one patient (5%) and malignant invasionof the scar in one patient (5%). Out of the thirty patients in group two 70% had successfulpleurodesis. Adverse effects included fever in five patients (17%), empyema in one patient (3%),and pulmonary infection in one patient (3%). No mortalities occurred during the procedures ineither of the group. Conclusions: Videoassisted thoracoscopic talc pleurodesis is a safe andeffective method of producing reliable pleurodesis in patients with malignant pleural effusion. It issuperior to pleurodesis via talc slurry through an intercostal drainage tube in terms of producinga reliable and complete pleurodesis. It should be performed early in patients presenting withmalignant pleural effusions to avoid the risk of respiratory failure, this being directly linked to thegeneral and respiratory status of the patients at the time of the procedure.