The use of single incision thoracoscopic pleurectomy in the management of malignant pleural effusion.
BACKGROUND
A number of procedures have been used in the management of malignant pleural effusion including repeated thoracentesis, tube thoracostomy, drainage with catheter, chemical pleurodesis, pleurectomy and pleuro-peritoneal shunt. However, the optimal method of management remains unclear. On the other hand, single incision thoracoscopic surgery has been defined as a less invasive method than the standard threeportal videothoracoscopy. We herein present our series of patients who underwent single incision thoracoscopic pleurectomy for malignant pleural effusion.


METHODS
We performed a single incision thoracoscopic pleurectomy in a total of 19 consecutive patients, 11 (57.8%) male and 8 (42.2%) female with a mean age of 56.3 +/- 16.9 years who had malignant pleural effusions. We made a single 2-2.5 cm incision at the seventh or eighth intercostal spaces on the midaxillary line for the procedure.


RESULTS
We performed a total of 23 single incision thoracoscopic total pleurectomies consisting of 11 (57.8%) right-sided, 4 (21.1%) left-sided and 4 (21.1%) bilateral procedures. The mean total postoperative drainage was 553 +/- 266 cc (Median; 470 cc), and the mean chest tube removal time was 2.3 +/- 0.4 days (Median; 2 days). We observed neither morbidity nor mortality. No patient required an additional port or a conversion to thoracotomy. Median follow-up was 83 days (range, 30 to 359 days). Pleural effusion recurred in two (8.6%) out of 23 procedures which resulted in a success rate as 91.4% for the procedure.


CONCLUSIONS
Single incision thoracoscopic pleurectomy is a safe, less invasive and an effective method of pleurodesis with a low recurrence rate in patients with malignant pleural effusion.
Department of Thoracic Surgery, Acibadem University School of Medicine, Turkey. murat19071966@gmail.com
M
M
Kara
S
S
Alzafer
E
E
Okur
S
S
Halezeroglu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016066:Pleural Effusion, Malignant / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D018700:Pleurodesis / Q000379:methods*; D011184:Postoperative Period; D013902:Radiography, Thoracic; D015996:Survival Rate / Q000639:trends; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult