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Single access videothoracoscopic biopsy and talc pleurodesisin patients with malignant pleural effusion

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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DOI: 10.1007/s13126-012-0047-4

Abstract

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 approach.
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 pleural effusions.

Item Type:Article
ID Code:9437
Status:Published
Refereed:Yes
Uncontrolled Keywords:Pleura, effusion, cancer, mesothelioma, VATS
Subjects:Area 06 - Scienze mediche > MED/18 Chirurgia generale
Divisions:001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Scienze Chirurgiche, Microchirurgiche e Mediche
Publisher:Springer Vienna
ISSN:0018-0092
eISSN:1868-8845
Deposited On:04 Dec 2013 08:23

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