Barbetakis Nikolaos, Asteriou Christos, Papadopoulou Fani, Samanidis Georgios, Paliouras Dimitrios, Kleontas Athanassios, Lyriti Konstantina, Katsikas Ioannis, Tsilikas Christodoulos
Thoracic Surgery Department, Theagenio Cancer Hospital, A, Simeonidi 2, Thessaloniki, 54007, Greece.
J Cardiothorac Surg. 2010 Apr 19;5:27. doi: 10.1186/1749-8090-5-27.
Malignant pleural effusion is a common sequelae in patients with certain malignancies. It represents a terminal condition with short median survival (in terms of months) and the goal is palliation. Aim of our study is to analyze morbidity, mortality and life expectancy following videothoracoscopic talc poudrage.
From September 2004 to October 2009, 400 patients underwent video-assisted thoracic surgery (VATS) for malignant pleural effusion. The conditions of patients were assessed and graded before and after treatment concerning morbidity, mortality, success rate of pleurodesis and median survival.
The median duration of follow up was 40 months (range 4-61 months). All patients demonstrated notable improvement in dyspnea. Intraoperative mortality was zero. The procedure was well tolerated and no significant adverse effects were observed. In hospital mortality was 2% and the pleurodesis success rate was 85%. A poor Karnofsky Performance Status and delay between diagnosis of pleural effusion and pleurodesis were statistically significant factors for in-hospital mortality. The best survival was seen in breast cancer, followed by ovarian cancer, lymphoma and pleural mesothelioma.
Video-assisted thoracoscopic talc poudrage is an effective and safe procedure that yields a high rate of successful pleurodesis and achieves long-term control with marked dyspnea decrease.
恶性胸腔积液是某些恶性肿瘤患者常见的后遗症。它代表一种终末期疾病，中位生存期较短（以月计），治疗目标是缓解症状。本研究的目的是分析电视胸腔镜滑石粉喷洒术后的发病率、死亡率和预期寿命。
2004年9月至2009年10月，400例患者因恶性胸腔积液接受电视辅助胸腔镜手术（VATS）。在治疗前后评估患者的发病率、死亡率、胸膜固定术成功率和中位生存期情况并进行分级。
中位随访时间为40个月（范围4 - 61个月）。所有患者呼吸困难均有显著改善。术中死亡率为零。该手术耐受性良好，未观察到明显不良反应。住院死亡率为2%，胸膜固定术成功率为85%。卡氏功能状态评分低以及胸腔积液诊断与胸膜固定术之间的延迟是住院死亡率的统计学显著因素。乳腺癌患者生存期最佳，其次是卵巢癌、淋巴瘤和胸膜间皮瘤患者。
电视辅助胸腔镜滑石粉喷洒术是一种有效且安全的手术，胸膜固定术成功率高，能显著减轻呼吸困难并实现长期控制。
