title: Minimally invasive surgical treatment of malignant pleural effusions.
abstract: BACKGROUND
  Usually the pleural cavity contains a small amount of liquid (approximately 10 ml). Pleural effusions appear when the liquid production rate overpasses the absorption rate with a greater amount of liquid inside the pleural cavity.
  
  
  METHODS
  Between January 1998 to December 2008 we conducted a study in order to establish the adequate surgical treatment for MPEs. Effective control of a recurrent malignant pleural effusion can greatly improve the quality of life of the cancer patient. The present review collects and examines the clinical results of minimally invasive techniques designed to treat this problem.
  
  
  CONCLUSIONS
  Patients with MPEs were studied according to several criteria. In our study we observed the superiority of intraoperative talc poudrage, probably due to a more uniform distribution of talc particles over the pleural surface. Minimal pleurotomy with thoracic drainage and instillation of a talc suspension is also a safe and effective technique and should be employed when there are contraindications for the thoracoscopic minimally invasive procedure.
  
  
  CONCLUSIONS
  On the basis of comparisons involving effectiveness, morbidity, and convenience, we recommend the thoracoscopic insufflations of talc as a fine powder with pleural drainage as the procedure of choice.
authors.affiliation: Department of Thoracic Surgery, "Dr. Carol Davila" Central Emergency University Military Hospital Bucharest, Romania.
authors.forename: Adrian
authors.initials: A
authors.lastname: Ciuche
authors.forename: Claudiu
authors.initials: C
authors.lastname: Nistor
authors.forename: Daniel
authors.initials: D
authors.lastname: Pantile
authors.forename: Teodor
authors.initials: T
authors.lastname: Prof Horvat