The use of single incision thoracoscopic pleurectomy in the management of malignant pleural effusion.

Abstract

BACKGROUND:

A number of procedures have been used in the management of malignant pleural effusion including repeated thoracentesis, tube thoracostomy, drainage with catheter, chemical pleurodesis, pleurectomy and pleuro-peritoneal shunt. However, the optimal method of management remains unclear. On the other hand, single incision thoracoscopic surgery has been defined as a less invasive method than the standard threeportal videothoracoscopy. We herein present our series of patients who underwent single incision thoracoscopic pleurectomy for malignant pleural effusion.

PATIENTS AND METHODS:

We performed a single incision thoracoscopic pleurectomy in a total of 19 consecutive patients, 11 (57.8%) male and 8 (42.2%) female with a mean age of 56.3 +/- 16.9 years who had malignant pleural effusions. We made a single 2-2.5 cm incision at the seventh or eighth intercostal spaces on the midaxillary line for the procedure.

RESULTS:

We performed a total of 23 single incision thoracoscopic total pleurectomies consisting of 11 (57.8%) right-sided, 4 (21.1%) left-sided and 4 (21.1%) bilateral procedures. The mean total postoperative drainage was 553 +/- 266 cc (Median; 470 cc), and the mean chest tube removal time was 2.3 +/- 0.4 days (Median; 2 days). We observed neither morbidity nor mortality. No patient required an additional port or a conversion to thoracotomy. Median follow-up was 83 days (range, 30 to 359 days). Pleural effusion recurred in two (8.6%) out of 23 procedures which resulted in a success rate as 91.4% for the procedure.

CONCLUSION:

Single incision thoracoscopic pleurectomy is a safe, less invasive and an effective method of pleurodesis with a low recurrence rate in patients with malignant pleural effusion.

• Authors: M Kara, S Alzafer, E Okur, S Halezeroglu
• Journal: Acta chirurgica Belgica (Acta Chir Belg) 2013 Jul-Aug Vol. 113 Issue 4 Pg. 270-4 ISSN: 0001-5458 [Print] England
• PMID: 24224436 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Drainage (methods)
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Staging
• Pleural Effusion, Malignant (diagnosis, mortality, surgery)
• Pleurodesis (methods)
• Postoperative Period
• Radiography, Thoracic
• Survival Rate (trends)
• Thoracic Surgery, Video-Assisted (methods)
• Tomography, X-Ray Computed
• Treatment Outcome
• Turkey (epidemiology)
• Young Adult