| The significance of thoracoscopic mechanical pleurodesis for the treatment of malignant pleural effusions. | |
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MedLine Citation:
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PMID: 15506307 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Malignant pleural effusion (MPE) is a frequent and serious complication of numerous malignant tumors in the human organism. The patients are suffering from the primary disease, and the pleural effusion causes dyspnea, thus reducing the quality of their survival time. In our study we wished to establish the significance of thoracoscopic mechanical pleurodesis (TMP) as a new method for the resolution of this pathology, by comparing the results with those of thoracotomy with pleurectomy (TP) and thoracic drainage (TD). The main criterion for the effectiveness of each method was the absence of pleural effusion in a certain time interval. PATIENTS AND METHODS: 84 patients with recurrent MPE and primary tumors at various locations were divided into three groups according to the type of palliative intervention. The patients were classified according to the indication guidelines for individual procedures and their general condition. Group 1 consisted of 44 patients in whom TMP was performed, group 2 consisted of 17 patients with primary tumors in the thoracic region in whom thoracotomy with pleurectomy (TP) was performed, and in group 3 there were 26 patients with TD. We compared the effectiveness of individual palliative methods by periodical X-ray checks, numbers of complications, length of TD and hospitalization, and changes in spirometric values after individual procedures. The t-test was used in statistic processing of the data. RESULTS: After six months, radiological investigation revealed recurrence of pleural effusion in three patients in group 1 (93.2% efficacy), no recurrence in group 2 (100% efficacy), and recurrence in 18 patients in group 3 (25.0% efficacy). There were fewer postoperative complications in group 1, the duration of TD and hospitalization was significantly shorter, and spirometric values increased. CONCLUSION: TMP is an effective palliative method for the treatment of recurrent pleural effusions, with a minimum number of complications and a short period of hospitalization. After TMP there is significant improvement in respiratory functions, and for the patient it represents a relatively simple surgical procedure. TP is indicated in the treatment of tumors and subsequent MPE in the thoracic region, and TD is indicated in patients who are not suitable candidates for one of the palliative pleurodesis procedures, because of either their poor general condition or a trapped lung. |
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Authors:
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Anton Crnjac |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article |
Journal Detail:
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Title: Wiener klinische Wochenschrift Volume: 116 Suppl 2 ISSN: 0043-5325 ISO Abbreviation: Wien. Klin. Wochenschr. Publication Date: 2004 |
Date Detail:
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Created Date: 2004-10-27 Completed Date: 2004-12-27 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 21620870R Medline TA: Wien Klin Wochenschr Country: Austria |
Other Details:
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Languages: eng Pagination: 28-32 Citation Subset: IM |
Affiliation:
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Department of Thoracic Surgery, Maribor Teaching Hospital, Maribor, Slovenia. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Drainage Female Humans Length of Stay Male Middle Aged Palliative Care Pleura / surgery Pleural Effusion, Malignant / classification, physiopathology, radiography, surgery, therapy* Pleurodesis / methods* Recurrence Spirometry Thoracic Surgery, Video-Assisted Thoracoscopy* Thoracotomy Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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