title: [Palliative treatment of malignant effusions by thoracoscopy under video-assistance: morbidity and survival].
abstract: Survival after surgical palliation of patients with malignant pleural effusions is expected to be of several months. From a group of 75 patients operated by video-assisted thoracic surgery (VATS) from September 1991 through March 1993, twenty-two of 38 patients with malignant disease underwent palliative surgery and operative morbidity and length of survival were studied. Palliation consisted in 20 talc pleurodesis and 2 pericardial windows for malignant effusions. In the 16 other patients with malignancy, video-thoracoscopy was done for diagnostic purposes. Thirty-day operative mortality was 13.6% (3/22) and the rate of operative morbidity was 31.8% (7/22). The follow-up was complete for all patients with a mean length of 5 months (+/- sd 4 months). During the follow-up period, 14 of 19 (74%) patients, alive 30 days after the procedure, were deceased at a mean of 3.4 +/- 4 months (6 patients < 3 months) after the operation. In all, 9 of 22 patients (40%) survived less than 3 months (median survival 4 months). Operative morbidity and mortality of video-thoracoscopy are high in the palliative group and only 60% of patients survived more than 3 months. More stringent criteria for selection of patients for palliative endosurgery should be defined.
authors.affiliation: Programme de Chirurgie Cardiovasculaire et Thoracique, Université de Montréal, Québec, Canada.
authors.forename: L P
authors.initials: LP
authors.lastname: Perrault
authors.forename: A
authors.initials: A
authors.lastname: Pagé
authors.forename: J
authors.initials: J
authors.lastname: Grégoire
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010166:Palliative Care; D016066:Pleural Effusion, Malignant / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D011859:Radiography; D015996:Survival Rate; D013906:Thoracoscopy / Q000379:methods*