Abstract
Introduction: Malignant pleural effusion is a common medical problem in patients with primary lung cncer or metastatic.It defines an advanced form of the disease and is an index of poor prognosis.Medical thoracoscopy(MTh) is a technique which primary used for the diagnosis but it also allows talc poudrage for controlling recurrent symptomatic malignant effusions.
Objective: To assess the efficacy,permanence and safety of Thoracoscopic talc poudrage(TTP) for pleurodesis in malignant effusions.
Method: A restrospective analysis was performed in 96 patients(46 males,50 females) who underwent TTP at our institution. The histological type of the malignancy were classified as following:primary lung cancer 32 patients, mesothelioma 28 and metastatic from other organs 36 patients(22 breast,14 other).
Results: The degree of response was estimated on 1st and 3st month.On the 1st month complete response(C.R.)was determined in 90 patients(93.7%) and progressive disease(P.D.) in 6(6.3%).On 3rd month C.R. was determined in 73 patients(76%),partial response(P.R.) in 9(9.4%) and P.D.in 14(14.6%).The overall response(O.R.)was 85.4% (lung cancer 81.3%,mesothelioma 82.2%,breast cancer 91%).The procedure was performed with no serious complications[subcutaneous emphysema in 9 patients(9.37%) and fever in 21(21.9%)].The thoracic drainage tube was removed after 1-10days(average:3.97).
Conclusion: TTP is a safe,well tolerated and effective procedure for drainage and pleurodesis for malignant pleural effusions.
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