Böhle A S, Kurdow R, Dohrmann P, Henne-Bruns D
Klinik für Allgemeine Chirurgie und Thoraxchirurgie, Christian-Albrechts-Universität Kiel.
Dtsch Med Wochenschr. 1999 Mar 26;124(12):341-5. doi: 10.1055/s-2007-1024304.
Definitive palliation of malignant pleural effusion demands a therapeutic procedure that is efficient with a low risk of complication and death. This study was undertaken to evaluate the outcome of thoracoscopic talcum pleurodesis (TTP), with insertion of pleuro-peritoneal shunt (PPS) for permanent drainage, if indicated.
The results of treating malignant pleural effusions were analysed retrospectively in 36 patients (15 men, 21 women; mean age 65 [48-89] years) who had undergone 37 video-assisted TTP and 6 PPS.
TTP achieved significant improvement of dyspnoea in 89% of patients and PPS succeeded in providing permanent internal drainage even in cases of adherent pleura.
Video-assisted TTP is the method of choice in the palliative treatment of malignant pleural effusions in the still expanding lung. In case of an adherent nonexpanding lung PPS provides effective and permanent palliation.
恶性胸腔积液的确定性姑息治疗需要一种疗效显著且并发症和死亡风险低的治疗方法。本研究旨在评估胸腔镜滑石粉胸膜固定术（TTP）的疗效，必要时插入胸膜-腹膜分流术（PPS）进行永久性引流。
回顾性分析36例患者（15例男性，21例女性；平均年龄65岁[48 - 89岁]）治疗恶性胸腔积液的结果，这些患者接受了37次电视辅助TTP和6次PPS。
TTP使89%的患者呼吸困难得到显著改善，PPS即使在胸膜粘连的情况下也成功实现了永久性内引流。
电视辅助TTP是仍在扩张的肺中恶性胸腔积液姑息治疗的首选方法。在肺粘连且不扩张的情况下，PPS可提供有效且永久性的姑息治疗。
