Alvarez Padilla Facundo Nicolás, Schiavoni Emiliano Nestor, Bustos Mario Eduardo Francisco
Hospital Privado. IUCBC.
Rev Fac Cien Med Univ Nac Cordoba. 2017 Dec 14;74(4):379-385. doi: 10.31053/1853.0605.v74.n4.17017.
Malignant pleural effusion (MPE) involves advanced cancer disease. Pleural biopsy for endoscopic thoracic surgery allows diagnosis in more than 90% of cases and instrumentation of the pleural space, improving the results of the technique.
We performed a retrospective analysis of patients with MPE who underwent a talc chemical pleurodesis. Two groups were formed, one with complicated malignant pleural effusion (CMPE) and another with uncomplicated malignant pleural effusion (NCMPE). In the group with CMPE, "release - expansion maneuvers" were performed. The variables between the two groups were compared for the relevant analysis.
We analyzed 28 patients with MPE treated with chemical pleurodesis by endoscopic thoracic surgery. The average age was 62.64 years. Pleural involvement due to breast disease was the most frequent form (46.4%). There was no difference between complication rate (p = 0.31) and the risk of death at 30 days (p = 1.09) with aggressive management of pleural space. The delay pleurodesis indication was related to a higher rate of complications (p = 0.002) and a higher probability of death within 30 days (p = 0.008). The majority of patients return to their daily tasks, with good tolerance to dyspnea following the procedure.
In patients with complicated MPE, the "lung-release maneuvers" described above would increase the chances of improving outcomes at low risk. Early chemical pleurodesis improves the quality of life of patients with PND.
恶性胸腔积液(MPE)涉及晚期癌症疾病。胸腔镜手术进行胸膜活检可使90%以上的病例得到诊断,并对胸膜腔进行操作,从而改善该技术的效果。
我们对接受滑石粉化学性胸膜固定术的MPE患者进行了回顾性分析。分为两组,一组为复杂性恶性胸腔积液(CMPE),另一组为非复杂性恶性胸腔积液(NCMPE)。在CMPE组中,进行了“松解 - 扩张操作”。比较两组之间的变量以进行相关分析。
我们分析了28例接受胸腔镜手术化学性胸膜固定术治疗的MPE患者。平均年龄为62.64岁。乳腺疾病导致的胸膜受累是最常见的形式(46.4%)。积极处理胸膜腔时,并发症发生率(p = 0.31)和30天内死亡风险(p = 1.09)之间没有差异。延迟进行胸膜固定术与更高的并发症发生率(p = 0.002)和30天内更高的死亡概率(p = 0.008)相关。大多数患者恢复了日常活动,术后对呼吸困难耐受性良好。
在复杂性MPE患者中,上述“肺松解操作”将增加低风险改善预后的机会。早期化学性胸膜固定术可改善PND患者的生活质量。