Examining the effectiveness of the treatment of malignant pleural effusions

BACKGROUND: The aim of this study was to analyze the results of pleurodesis for malignant pleural effusion performed in our departmentPATIENTS AND METHODS: From June 2003 to March 2010, a series of 105 patients with malignant pleural effusion underwent a palliative pleurodesis, in Dicle University Faculty of Medicine Department of Thoracic Surgery. There were 58 females (55.2%) and 47 males (44.8%), ranging in age from 25 to 96 years (mean age: 56.19 years). The effusion was on the right side in 52 patients (49.5%), on the left side in 44 (41.9%), and bilateral in 9 (8.5%).Talc slurry with tube thoracostomy was performed for 48 patients (45.7%). Tetracycline was used for pleuredesis for 27 patients (25.7%). Twenty-six (24.7%) patients were underwent thoracoscopic talc poudrage. Pleuroctomy was performed in four patients. Video-thoracoscopy was performed under general anaesthesia in all patients. Pleurodesis was produced by instillation of 4g of sterile asbestos-free talc. The chest tube was removed when fluid drainage was less than 100 ml/24 h.RESULTS: Primary malignities were as follows; 42 (40%) malignant pleural mesothelioma, 26 (24%) breast cancer, 20 (19%) NSCLC, 3 GIS malignancy, 2 SCLC, 2 renal malignancy, 2 ovary tumours, one neurogenic malignancy, one lymhoma. The diagnosis was not possible in six patients. Pleurodesis success rate was 96.1 % for VATS talc poudrage, 70.8 % for talc slurry, and 70.3% for tetracycline. Level of pleural LDH was effective on pleuredesis (p<0.05). Video- assisted thoracoscopic talc poudrage was significantly effective than other methods (p<0.05).CONCLUSIONS: Video-assisted thoracoscopic talc poudrage is an effective and safe procedure that yields a high rate of successful pleurodesis and achieves long-term control with marked dyspnea decrease.