Jung Seop Eom1,2, Hyo Yeong Ahn3, Jeong Ha Mok1, Geewon Lee4, Eun-Jung Jo1, Mi-Hyun Kim1, Kwangha Lee1, Ki Uk Kim1, Hye-Kyung Park1, Min Ki Lee1. 1. Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea. 2. Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea. 3. Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Busan, Republic of Korea. 4. Department of Radiology, Pusan National University School of Medicine, Busan, Republic of Korea.
Abstract
BACKGROUND: Talc poudrage during thoracoscopy is considered the standard procedure for patients with symptomatic malignant pleural effusion (MPE). Until now, no alternative technique other than talc poudrage for pleurodesis during medical thoracoscopy has been proposed. Liquid sclerosants, such as mistletoe extract, have been sprayed evenly into the pleural cavity during semirigid pleuroscopy for chemical pleurodesis. OBJECTIVE: We conducted a retrospective study using the database of semirigid pleuroscopy to identify the usefulness of pleurodesis using a mistletoe extract delivered via a spray catheter during semirigid pleuroscopy for symptomatic MPE. METHODS: All consecutive patients with symptomatic MPE who underwent semirigid pleuroscopy from October 2015 to September 2016 were registered. The responses were evaluated using chest X- ray or computed tomography 4 weeks after pleurodesis. RESULTS: The study included 43 patients who underwent pleurodesis with mistletoe extract via a spray catheter during semirigid pleuroscopy. Complete and partial responses were seen in 21 (49%) and 19 (44%) patients, respectively. The median duration of chest tube placement after pleurod-esis was 7 days (range 6-8 days) in the 40 patients with complete or partial responses. No cases of severe hemorrhage, empyema formation, respiratory failure, or procedure-related mortality were observed in the subjects at 4 weeks after semirigid pleuroscopy. CONCLUSION: Pleurodesis with mistletoe extract delivered via a spray catheter during semirigid pleuroscopy is a safe and effective procedure for managing symptomatic MPE.
BACKGROUND: Talc poudrage during thoracoscopy is considered the standard procedure for patients with symptomatic malignant pleural effusion (MPE). Until now, no alternative technique other than talc poudrage for pleurodesis during medical thoracoscopy has been proposed. Liquid sclerosants, such as mistletoe extract, have been sprayed evenly into the pleural cavity during semirigid pleuroscopy for chemical pleurodesis. OBJECTIVE: We conducted a retrospective study using the database of semirigid pleuroscopy to identify the usefulness of pleurodesis using a mistletoe extract delivered via a spray catheter during semirigid pleuroscopy for symptomatic MPE. METHODS: All consecutive patients with symptomatic MPE who underwent semirigid pleuroscopy from October 2015 to September 2016 were registered. The responses were evaluated using chest X- ray or computed tomography 4 weeks after pleurodesis. RESULTS: The study included 43 patients who underwent pleurodesis with mistletoe extract via a spray catheter during semirigid pleuroscopy. Complete and partial responses were seen in 21 (49%) and 19 (44%) patients, respectively. The median duration of chest tube placement after pleurod-esis was 7 days (range 6-8 days) in the 40 patients with complete or partial responses. No cases of severe hemorrhage, empyema formation, respiratory failure, or procedure-related mortality were observed in the subjects at 4 weeks after semirigid pleuroscopy. CONCLUSION: Pleurodesis with mistletoe extract delivered via a spray catheter during semirigid pleuroscopy is a safe and effective procedure for managing symptomatic MPE.
Authors: Jong Duk Kim; Jae Won Choi; Hyun Oh Park; Chung Eun Lee; In Seok Jang; Jun Young Choi; Dong Hoon Kang; Jae Jun Jung; Jun Ho Yang; Sung Ho Moon; Joung Hun Byun; Sung Hwan Kim; Jong Woo Kim Journal: J Thorac Dis Date: 2020-10 Impact factor: 2.895