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合并腹水是否会影响恶性肿瘤患者胸腔积液姑息性手术治疗的效果?

Do concomitant ascites influence the effectiveness of palliative surgical management of pleural effusion in patients with malignancies?

作者信息

Gross Jefferson Luiz, Disanzio Tatiana Guilherme, Younes Riad Naim, Haddad Fabio José, da Silva Rodrigo Afonso, Avertano Antonio Bomfim Marçal

机构信息

Department of Thoracic Surgery, Hospital A. C. Camargo, Rua Prof Antonio Prudente, 211, CEP: 01509-001, São Paulo, Brazil.

出版信息

World J Surg. 2009 Feb;33(2):266-71. doi: 10.1007/s00268-008-9839-7.

Abstract

BACKGROUND

Both pleural and peritoneal effusions are associated with dismal prognosis for patients with malignancies. Pleural effusion often requires surgical palliative management to relieve symptoms. The aim of this study was assess the influence of concomitancy of ascites on the success rate of surgical management of pleural effusion in patients with solid malignancies.

METHODS

We retrospectively identified 33 patients with different primary malignancies, who underwent palliative surgical treatment for pleural effusion with concomitant ascites. The success rate of pleural effusion management was compared to that of a control group of patients with pleural effusion without ascites.

RESULTS

Ovarian and breast cancer were the most common primary sites in the group of patients with pleural and peritoneal effusions. Thoracocentesis was performed in 30 patients with concomitant ascites and in 29 patients without ascites. The median number of thoracocentesis procedures was two in both groups of patients. Talc pleurodesis was performed in 57.6 and 63.3% of patients with and without ascites, respectively. The success rate of pleurodesis was 68.4 and 71.9% for patients with and without concomitant ascites (P = 0.92), respectively. There was no significant difference in the median length of time of the chest tube placement between the two groups (with ascites, 6 days; without ascites, 5 days, P = 0.38). The overall survival was 5.6 months for patients with ascites and 7.8 months for patients without ascites (P = 0.51).

CONCLUSION

Our results suggest that concomitant ascites did not influence the effectiveness of palliative surgical management of pleural effusion in patients with malignancies.

摘要

背景

恶性肿瘤患者出现胸腔积液和腹腔积液均提示预后不良。胸腔积液常需手术姑息治疗以缓解症状。本研究旨在评估腹水并存对实体恶性肿瘤患者胸腔积液手术治疗成功率的影响。

方法

我们回顾性纳入了33例不同原发性恶性肿瘤患者,这些患者因胸腔积液合并腹水接受了姑息性手术治疗。将胸腔积液治疗成功率与无腹水的胸腔积液患者对照组进行比较。

结果

卵巢癌和乳腺癌是胸腔积液和腹腔积液患者组中最常见的原发部位。30例合并腹水的患者和29例无腹水的患者接受了胸腔穿刺术。两组患者胸腔穿刺术的中位数均为两次。分别有57.6%和63.3%有腹水和无腹水的患者接受了滑石粉胸膜固定术。有腹水和无腹水患者的胸膜固定术成功率分别为68.4%和71.9%(P = 0.92)。两组胸腔闭式引流管放置时间的中位数无显著差异(有腹水组为6天;无腹水组为5天,P = 0.38)。有腹水患者的总生存期为5.6个月,无腹水患者为7.8个月(P = 0.51)。

结论

我们的结果表明,腹水并存并不影响恶性肿瘤患者胸腔积液姑息性手术治疗的有效性。

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