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2008 | 80 | 1 | 35-41
Tytuł artykułu

Diagnostic and Therapeutic Thoracoscopy (Videothoracoscopy) in Malignant Pleural Effusion - Our Experience

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EN
Abstrakty
EN
Diagnosis and treatment of patients with malignant pleural effusion (MPE) is a serious problem for clinicians.The aim of the study were: to evaluate the diagnostic and therapeutic value of thoracoscopy and videothoracoscopy (VTS) and to determine the efficiency of using talc for the management of MPE.Material and methods. Between January 1996 and December 2006, thoracoscopy (VTS) was performed in 95 patients. A 4 g dose of talc was used for pleurodesis. Out of the 95 diagnostic procedures, malignancy was diagnosed in 94 (98.9%) patients. Patients were divided into two subgroups: subgroup A, patients (n=4) who died within first month, and subgroup B, patients (n=91) who lived more than one month. In subgroup A, complete remission (CR) was achieved in four (100%) patients until they died. In subgroup B, CR was achieved in 90 (98.9%) patients after one month, with relapse (R) occurring in 1 (1.1%) patient. After three months, CR was achieved in 86 (94.5%), partial remission (PR) in three (3.3%), and R in two (2.2%) patients. After six and nine months, CR was achieved in 85 (93.4%), PR in three (3.3%), and R in three (3.3%) patients. Postoperative complications, side effects after applying talc, and general performance were assessed. Difficulties in lung expansion requiring redrainage occurred in four (4.2%) patients. Fever appeared in 79 (83.2%) patients, while pain appeared in 90 (94.7%) patients. After treatment, the number of patients classified as I on the WHO scale increased from 36.8% to 74.7%, while the number of patients classified as III on the WHO scale decreased from 10.5% to 2.1%.Conclusions. Thoracoscopy (VTS) significantly improves diagnostic effectiveness in cases without cytological and histological diagnosis and is a method of treatment for MPE. Very good results were achieved after intrapleural administration of talc (CR occurred in 93.4% patients). The most common side effect of administering talc was pain.
Słowa kluczowe
Wydawca

Rocznik
Tom
80
Numer
1
Strony
35-41
Opis fizyczny
Daty
wydano
2008-01-01
online
2008-02-18
Twórcy
  • Wrocław Thoracic Surgery Centre: Department of Thoracic Surgery of Lower Silesian Centre of Lung Diseases, Medical University, Wrocław
  • Wrocław Thoracic Surgery Centre: Department of Thoracic Surgery of Lower Silesian Centre of Lung Diseases, Medical University, Wrocław
  • Wrocław Thoracic Surgery Centre: Department of Thoracic Surgery of Lower Silesian Centre of Lung Diseases, Medical University, Wrocław
  • Wrocław Thoracic Surgery Centre: Department of Thoracic Surgery of Lower Silesian Centre of Lung Diseases, Medical University, Wrocław
  • Wrocław Thoracic Surgery Centre: Department of Thoracic Surgery of Lower Silesian Centre of Lung Diseases, Medical University, Wrocław
Bibliografia
  • Droszcz W i wsp.: Choroby opłucnej. Wydawnictwo Lekarskie PZWL, Warszawa 1997.
  • Kacprzak G, Gabryś K: Optymalizacja leczenia chirurgicznego chłonkotoków opłucnowych. Pol Przegl Chir 2000; 72(4): 381-86.
  • Kacprzak G, Kołodziej J, Rzechonek A et al.: Management of malignant pleural effusion. W: Second International Congress of Thorax Surgery. June 24-26, 1998, Bologna, Italy. Editrice Compositori 1998; 325-30.
  • Taubert J: Management of malignant pleural effusion. Nurs Clin North Am 2001; 36(4): 665-83.[PubMed]
  • Pietsch JB, Whitlock JA, Ford C et al.: Management of Pleural Effusions in Children with Malignant Lymphoma. J Pediatr Surg 1999; 34: 635-38.[PubMed][Crossref]
  • Little AG: Thoracoscopy: current status. Curr Opin Pulm Med 1996; 2: 315-19.[PubMed]
  • Jabłonka S: Miejsce videotorakoskopii w chirurgii klatki piersiowej. W: 56. Zjazd Towarzystwa Chirurgów Polskich. Lublin 8-11 września 1993. Streszczenia II: 426. POL-ILKO Lublin 1993.
  • Lewis RJ, Caccavale RJ, Sisler GE: Imaged thoracoscopic lung biopsy. Chest 1992; 102(1): 60-62.[Crossref][PubMed]
  • Loddenkemper R, Boutin C: Thoracoscopy: present diagnostic and therapeutic indications. Eur Respiro J 1993; 6: 1544-55.
  • American Thoracic Society. Management of Malignant Pleural Effusions. Am J Respiro Crit Care Med 2000; 162: 1987-2001.
  • Antony VB, Loddenkemper R, Astoul P et al.: Management of malignant pleural effusions. Eur Respir J 2001; 18: 402-19.[Crossref][PubMed]
  • Weatherford DA, Stephenson JE, Taylor SM et al.: Thoracoscopy versus thoracotomy: indications and advantages. Am Surg 1995; 61(1): 83-86.[PubMed]
  • Yap KP, Tan NC: Video-assisted thoracoscopy: role in the management of intrathoracic pathology. Ann Acad Med Singapore 1999; 28(6): 816-18.[PubMed]
  • Stella F, Ansaloni L, Bini A et al.: VATS value in the diagnosis, staging and pallative treatment of malignant pleural mesothelioma. W: Second International Congress of Thorax Surgery. June 24-26, 1998, Bologna, Italy. Editrice Compositori 1998; 325-30.
  • Ross RT, Burnett CM: Talc pleurodesis: a new technique. Am Surg 2001; 67(5): 467-68.[PubMed]
  • Rodriguez-Panadero F: Malignant pleural diseases. Monaldi Arch Chest Dis 2000; 55: 1, 17-19.
  • Chhieng DC, Ko EC, Yee HT: Malignant pleural effusions due to small-cell lung carcinoma: a cytologic and immunocytochemical study. Diagn Cytopathol 2001; 25(6): 356-60.[Crossref][PubMed]
  • Braunschweig R, Guilleret I, Delacretaz F: Pitfalls in TRAP assay in routine detection of malignancy in effusions. Diagn Cytopathol 2001; 25(4): 225-30.[Crossref][PubMed]
  • Boutin C, Viallat JR, Cargnino P et al.: Thoracoscopy in malignant pleural effusions. Am Rev Respir Dis 1981; 124: 588-92.
  • Cardillo G, Facciolo F, Carbone L et al.: Longterm follow-up of video-assisted talc pleurodesis in malignant recurrrent pleural effusions. Eur J Cardiothorac Surg 2002; 21: 302-06.[Crossref]
  • Schulze M, Boehle AS, Kurdow R et al.: Effective Treatment of Malignant Pleural Effusion by Minimal Invasive Thoracic Surgery: Thoracoscopic Talc Pleurodesis and Pleuroperitoneal Shunts in 101 Patients. Ann Thorac Surg 2001; 71: 1809-12.
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_v10035-007-0130-7
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