Palliative treatment of malignant pleural effusions.

AIM: The aim of the current study was to analyse the results of video assisted thoracoscopic (VATS) talc pleurodesis for malignant pleural effusion.

MATERIAL AND

METHODS

From January 2002 to December 2004, 50 VATS procedures were performed under general anaesthesia on 48 patients for malignant pleural effusion. There were 45 women and 3 men with a median age of 57 years. The most common primary neoplasms were breast cancer (68%), ovarian cancer (6%), colon cancer (4%) and lung cancer (4%). Five patients had other types of tumour, including malignant lymphoma, fibrosarcoma, renal cell carcinoma, malignant pleural mesothelioma, acute myeloblastic leukaemia.

RESULTS

The average duration of the operation was 46 min (range 20-120). Median duration of postoperative drainage was 5 days (range 2-13) and postoperative hospitalisation was 8 days (range 2-13). Four patients had postoperative complications. Thirty-day mortality was 1/48. One patient died from myocardial infarction. Three postoperative complications were noted (one non-septic febrile episode, one bilateral pneumopathy and one transitory hypoxaemia, treated by non invasive ventilation). Patients were relieved from dyspnoea in 34/48 of the cases (71%). Median survival was 6 months (ranging from 14 days to 2 years).

CONCLUSIONS

Early talc pleurodesis via VATS is a safe technique for successfully treating pleural effusion and preventing recurrence in palliative patients with a symptomatic malignant pleural effusion.