Document Detail


Video-assisted thoracoscopic (VATS) pleurodesis for malignant effusion: an Australian teaching hospital's experience.
MedLine Citation:
PMID:  16352262     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is commonly employed to achieve pleurodesis in patients suffering malignant pleural effusion (MPE). AIMS.: To evaluate the utility and outcome of VATS pleurodesis in management of MPE. METHODS: Two hundred and two consecutive VATS pleurodesis for MPE were evaluated. Data was derived from a prospectively maintained database and hospital records. Pleurodesis was deemed unsuccessful if a significant effusion occurred within 30 days of surgery. RESULTS: VATS pleurodesis was successful in 88% of patients (failure 12%) while recurrence of effusion occurred in 18%. Post-operative air space, air leak, empyema and prolonged intercostal catheter drainage (>14 days) were all significantly associated with a failed procedure. Mean length of stay was 10.4 days and 42% of patients were discharged within 7 days of surgery. Morbidity was 20% with no operative deaths and median survival was 94 days. Inpatient mortality was 5%. High ASA (>or=4) was significantly associated with increased risk of inpatient death (p<0.001) and poorer long-term survival (43 days versus 133 days, p=0.05). CONCLUSIONS: VATS pleurodesis offers reasonable palliation of MPE with low morbidity and rapid recovery. Patients with an ASA score of >or=4 have a poor overall outcome and warrant less invasive palliative measures.
Authors:
Dean Trotter; Ahmad Aly; Lyndon Siu; Simon Knight
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart, lung & circulation     Volume:  14     ISSN:  1443-9506     ISO Abbreviation:  Heart Lung Circ     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-12-14     Completed Date:  2006-01-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100963739     Medline TA:  Heart Lung Circ     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  93-7     Citation Subset:  IM    
Affiliation:
Austin Hospital, Melbourne, Australia. deantrotter@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Hospitals, Teaching
Humans
Length of Stay
Male
Middle Aged
Pleural Effusion, Malignant / therapy*
Pleurodesis / methods
Prospective Studies
Recurrence
Retrospective Studies
Thoracic Surgery, Video-Assisted*
Treatment Outcome
Victoria

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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