Department of Internal Medicine, Pusan National University School of Medicine, Busan, Republic of Korea.
Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
Respiration. 2018;95(3):177-181. doi: 10.1159/000481869. Epub 2017 Nov 7.
Talc poudrage during thoracoscopy is considered the standard procedure for patients with symptomatic malignant pleural effusion (MPE). Until now, no alternative technique other than talc poudrage for pleurodesis during medical thoracoscopy has been proposed. Liquid sclerosants, such as mistletoe extract, have been sprayed evenly into the pleural cavity during semirigid pleuroscopy for chemical pleurodesis.
We conducted a retrospective study using the database of semirigid pleuroscopy to identify the usefulness of pleurodesis using a mistletoe extract delivered via a spray catheter during semirigid pleuroscopy for symptomatic MPE.
All consecutive patients with symptomatic MPE who underwent semirigid pleuroscopy from October 2015 to September 2016 were registered. The responses were evaluated using chest X- ray or computed tomography 4 weeks after pleurodesis.
The study included 43 patients who underwent pleurodesis with mistletoe extract via a spray catheter during semirigid pleuroscopy. Complete and partial responses were seen in 21 (49%) and 19 (44%) patients, respectively. The median duration of chest tube placement after pleurod-esis was 7 days (range 6-8 days) in the 40 patients with complete or partial responses. No cases of severe hemorrhage, empyema formation, respiratory failure, or procedure-related mortality were observed in the subjects at 4 weeks after semirigid pleuroscopy.
Pleurodesis with mistletoe extract delivered via a spray catheter during semirigid pleuroscopy is a safe and effective procedure for managing symptomatic MPE.
胸腔镜下滑石粉撒布术被认为是治疗有症状的恶性胸腔积液（MPE）患者的标准程序。到目前为止，除了滑石粉撒布术之外，还没有其他方法可用于胸腔镜下的胸膜固定术。在半刚性胸腔镜检查中，为了进行化学性胸膜固定术，槲寄生提取物等液体硬化剂均匀地喷洒到胸腔内。
我们使用半刚性胸腔镜检查数据库进行了一项回顾性研究，以确定在半刚性胸腔镜检查中使用喷雾导管输送槲寄生提取物进行胸膜固定术治疗有症状的 MPE 的效果。
所有在 2015 年 10 月至 2016 年 9 月期间因有症状的 MPE 而行半刚性胸腔镜检查的连续患者均被登记。在胸膜固定术 4 周后，通过胸部 X 射线或计算机断层扫描评估反应。
本研究纳入了 43 例在半刚性胸腔镜检查中使用喷雾导管输送槲寄生提取物进行胸膜固定术的患者。21 例（49%）和 19 例（44%）患者分别出现完全和部分反应。在完全或部分反应的 40 例患者中，胸膜固定术后放置胸腔引流管的中位时间为 7 天（范围为 6-8 天）。在半刚性胸腔镜检查 4 周后，所有患者均未出现严重出血、脓胸形成、呼吸衰竭或与操作相关的死亡。
在半刚性胸腔镜检查中使用喷雾导管输送槲寄生提取物进行胸膜固定术是一种安全有效的治疗有症状的 MPE 的方法。
