Chen Juan, Li Zhu, Xu Ning, Zhang Xin, Wang Yu, Lin Dianjie
Department of Respiratory, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan 250100, Shandong, China; Liaocheng People's HospitalLiaocheng 252004, Shandong, China.
Liaocheng People's Hospital Liaocheng 252004, Shandong, China.
Int J Clin Exp Med. 2015 Oct 15;8(10):18945-53. eCollection 2015.
The aim of this study was to assess the efficacy and complications and compare the efficacy of medical thoracoscopic talc pleurodesis among patients with different types of tumors and different pathological classifications of lung cancer as well as to evaluate the role of postoperative negative pressure chest tube drainage. A total of 1061 patients with malignant pleural effusion who underwent thoracoscopic pleurodesis were analyzed retrospectively. The complications, postoperative drainage time, and efficacy of pleurodesis among patients with different types of tumors and different pathological classifications of lung cancer were assessed. The overall response rate (ORR) was 88.03%. Major complications included chest pain (68%) and fever (47%). The postoperative drainage time was 4.74 ± 1.56 days. Postoperative negative pressure chest tube drainage significantly shortened the drainage time (negative vs. non-negative: 4.56 ± 1.49 days vs. 4.81 ± 1.59 days, P = 0.037). Pleurodesis was less effective in treating effusion caused by lung cancer (72.3%) and mesothelioma (68.2%) than that caused by breast cancer (84.4%) and other tumors (87.8%) (P = 0.009). The efficacy in the treatment of effusion caused by adenocarcinoma (66.7%) was slightly less than that caused by other types of lung cancer (P = 0.311). In conclusion, medical thoracoscopic talc pleurodesis is a palliative and effective treatment for malignant pleural effusion. In addition, postoperative simple negative pressure chest tube drainage significantly shortens the drainage time. However, thoracoscopic pleurodesis is less effective for the treatment of effusion caused by lung cancer and pleural mesothelioma compared with that caused by other types of cancers.
本研究旨在评估疗效及并发症，并比较不同类型肿瘤及不同病理分类的肺癌患者行内科胸腔镜滑石粉胸膜固定术的疗效，同时评估术后负压胸腔闭式引流的作用。回顾性分析了1061例行胸腔镜胸膜固定术的恶性胸腔积液患者。评估了不同类型肿瘤及不同病理分类的肺癌患者的并发症、术后引流时间及胸膜固定术的疗效。总有效率（ORR）为88.03%。主要并发症包括胸痛（68%）和发热（47%）。术后引流时间为4.74±1.56天。术后负压胸腔闭式引流显著缩短了引流时间（负压引流组与非负压引流组：4.56±1.49天 vs. 4.81±1.59天，P = 0.037）。胸膜固定术治疗肺癌（72.3%）和间皮瘤（68.2%）引起的胸腔积液的疗效低于乳腺癌（84.4%）和其他肿瘤（87.8%）引起的胸腔积液（P = 0.009）。腺癌（66.7%）引起的胸腔积液的治疗效果略低于其他类型肺癌（P = 0.311）。总之，内科胸腔镜滑石粉胸膜固定术是治疗恶性胸腔积液的一种姑息性有效方法。此外，术后单纯负压胸腔闭式引流显著缩短了引流时间。然而，与其他类型癌症相比，胸腔镜胸膜固定术治疗肺癌和胸膜间皮瘤引起的胸腔积液的效果较差。
