Comparing the results of VATS pleurectomy and pleurocan plus talc pleurodesis in randomysed patients with malign pleural effusion

Pleural effusion occurs as a result of detoriation in equilibrium between absorption and secretion of pleural liquid. In this study, we aimed to investigate the effect and clinical responses of talk pleurodesis and pleurectomy with video assisted thoracoscopic surgery (VATS) in patients with malignant pleural effusionForty-five patients with malignant pleural effusion who were treated with pleurodesis between June 2007 and June 2008 were included in this study. Thoracentesis was performed in order to study the biochemical, microbiologic and cytological analysis. Glucose, total protein, albumine, LDH and cytological examination were studied in effusion and blood sample simultaneaously. Cases were classified into two groups; in group 1 (n=25), small calibrated cathater and talk pleurodesis were performed. In Group 2 (n=20), VATS pleurectomy was performedThere were 32 females and 13 males with mean age 51.58 (27-75). Diagnosis was made with cytologic examination of pleural fluid that was aspirated with thoracentesis. Transudate and exudate discrimination was done according to Light criteria. Breast cancer was the most malignant effusion etiology (19 patients-42.22%). Lung cancer (10 patients-22,22%) was the second one. Succes rates of the groups were as complete response; in group 1(TALC) was 64% (n=16) where 60% in group 2 (n=12). Partial response was 20% in Group 1 and 25% in Group 2. Unsuccesfull response was 16% (n=4) in Group 1 and 15% (n=3) in Group 2. There was no significant difference between groups when hospital stay and tube drainage time when compared to eachother. The treatment of malignant pleural effusion is palliative as it is a poor prognostic factor. The purpose is to eliminate dyspnea in patients whit short survival time. There was no significant difference between the VATS pleurectomy method and talc pleurodesis that has been known as effective sclerosant agent.Key Words: Malign pleural effusion, Thoracoscopy, Talc, Pleurodesis