title: Video-thoracoscopic surgical pleurodesis in the management of malignant pleural effusion: the importance of an early intervention.
abstract: Thoracentesis plays an important role in cancer patients with symptomatic effusions, although its effect is short-lived and symptoms recur in almost all patients. Early video-thoracoscopic surgical pleurodesis may provide added benefit to a group of patients with advanced cancer presenting with symptomatic malignant pleural effusion. Seventy-six patients with advanced cancer and pleural effusion due to pulmonary-pleural metastases were recruited. In 51 cases (67.1%), at least one thoracentesis was performed before admission for surgery. Preoperative staging consisted of chest radiograph, CT scan, and blood gas analysis. The mean Karnofsky performance status was about 50. Pleurodesis with talc poudrage was completely successful in all patients, with a morbidity rate of 2.6%. There was no post-operative mortality. Three patients (3.9%) underwent further thoracenteses for recurrence of pleural effusion within two months after the procedure. Early use of talc insufflated by video-thoracoscopic surgery is an effective and relatively safe method for treating pleural effusion, and preventing recurrence, in advanced cancer patients.
authors.affiliation: Department of Experimental Oncology and Clinical Application, University of Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Marrazzo
authors.forename: Antonio
authors.initials: A
authors.lastname: Noto
authors.forename: Luigi
authors.initials: L
authors.lastname: Casà
authors.forename: Pietra
authors.initials: P
authors.lastname: Taormina
authors.forename: Domenico
authors.initials: D
authors.lastname: Lo Gerfo
authors.forename: Massimo
authors.initials: M
authors.lastname: David
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Mercadante
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000401:mortality* / Q000628:therapy*; D018700:Pleurodesis / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000601:surgery*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D013627:Talc / Q000627:therapeutic use*; D020775:Thoracic Surgery, Video-Assisted / Q000706:statistics & numerical data*; D016896:Treatment Outcome
chemical_list: D013627:Talc