INTRODUCTION: Usually the pleural cavity contains a small amount of liquid (approximately 10 ml). Pleural effusions appear when the liquid production rate overpasses the absorption rate with a greater amount of liquid inside the pleural cavity. MATERIAL AND METHOD: Between January 1998 to December 2008 we conducted a study in order to establish the adequate surgical treatment for MPEs. Effective control of a recurrent malignant pleural effusion can greatly improve the quality of life of the cancer patient. The present review collects and examines the clinical results of minimally invasive techniques designed to treat this problem. RESULTS AND DISCUSSION: Patients with MPEs were studied according to several criteria. In our study we observed the superiority of intraoperative talc poudrage, probably due to a more uniform distribution of talc particles over the pleural surface. Minimal pleurotomy with thoracic drainage and instillation of a talc suspension is also a safe and effective technique and should be employed when there are contraindications for the thoracoscopic minimally invasive procedure. CONCLUSIONS: On the basis of comparisons involving effectiveness, morbidity, and convenience, we recommend the thoracoscopic insufflations of talc as a fine powder with pleural drainage as the procedure of choice.
INTRODUCTION: Usually the pleural cavity contains a small amount of liquid (approximately 10 ml). Pleural effusions appear when the liquid production rate overpasses the absorption rate with a greater amount of liquid inside the pleural cavity. MATERIAL AND METHOD: Between January 1998 to December 2008 we conducted a study in order to establish the adequate surgical treatment for MPEs. Effective control of a recurrent malignant pleural effusion can greatly improve the quality of life of the cancerpatient. The present review collects and examines the clinical results of minimally invasive techniques designed to treat this problem. RESULTS AND DISCUSSION: Patients with MPEs were studied according to several criteria. In our study we observed the superiority of intraoperative talc poudrage, probably due to a more uniform distribution of talc particles over the pleural surface. Minimal pleurotomy with thoracic drainage and instillation of a talc suspension is also a safe and effective technique and should be employed when there are contraindications for the thoracoscopic minimally invasive procedure. CONCLUSIONS: On the basis of comparisons involving effectiveness, morbidity, and convenience, we recommend the thoracoscopic insufflations of talc as a fine powder with pleural drainage as the procedure of choice.
Authors: J C Ruckdeschel; D Moores; J Y Lee; L H Einhorn; I Mandelbaum; J Koeller; G R Weiss; M Losada; J H Keller Journal: Chest Date: 1991-12 Impact factor: 9.410