Attene, Federico and Paliogiannis, Panagiotis and Scognamillo, Fabrizio and Marrosu, Antonio and Trignano, Mario (2012) Single access videothoracoscopic biopsy and talc pleurodesisin patients with malignant pleural effusion. Hellenic Journal of Surgery, Vol. 84 (5), p. 304-307. ISSN 0018-0092. eISSN 1868-8845. Article.
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Aim-Background: Recurrent pleural effusion is frequently
observed in clinical experience and malignancy
is one of the most frequent causes. Although
it is generally necessary to prevent the recurrence of
effusion in patients with disseminated neoplastic disease,
in others, a diagnosis is required. The aim of
this study was to determine the efficacy and safety of
biopsy and pleurodesis by a single access videothoracoscopic
Methods: We report a consecutive series of 20 patients
(12 men, 8 women, aged 39 to 83 years) who underwent
single access videothoracoscopy with pleural
biopsy and talc pleurodesis for recurrent pleural effusion.
In all cases, indication for the procedure was a
recurrent pleural effusion, suspicious for malignancy.
Videothoracoscopy was performed under general
anaesthesia. For pleurodesis, an average of 8g of sterile
talc powder was used. A six-month follow-up was
completed for all patients, and efficacy was judged by
clinical examination and chest X-ray.
Results: Diagnosis was obtained in all cases. In five
cases, the diagnosis was a pleural involvement by
breast cancer metastasis, and in four cases, a primary
lung cancer was detected. Eight were mesotheliomas
and one a parapneumonic collection. In two cases, an
unknown-malignancy recurrent pleural effusion was
observed. No deaths, talc-induced ARDS or malignant
invasion of the scar occurred, but only a postoperative
empyema and two subcutaneous emphysemas
treated successfully without further operation.
Conclusions: Single access videothoracoscopic pleural
biopsy and talc pleurodesis is a safe and effective
method for the diagnosis and treatment of malignant
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