Garzón Juan Carlos, Edward Vinck Eric, Carolina Cárdenas Diana, Jaime Téllez Luis
Department of Thoracic Surgery and Lung Transplant, Fundación Cardioinfantil, Bogota, Colombia.
J Cardiovasc Thorac Res. 2020;12(4):328-333. doi: 10.34172/jcvtr.2020.52. Epub 2020 Dec 1.
In developing countries where talc may not be readily available, video-assisted thoracoscopic (VATS) iodopovidone pleurodesis offers an excellent alternative for the treatment of malignant pleural effusions (MPEs). This study analyzes a retrospective experience using VATS iodopovidone pleurodesis for malignant pleural effusions at a single cardiothoracic center in the capital of Colombia evaluating success according to LENT (Lactate, Eastern Cooperative Oncology Group-ECOG, Neutrophil-Lymphocyte ratio, Tumor type) scores. A total of 75 records of patients taken to VATS iodopovidone pleurodesis for MPEs were retrieved from our institutional database during a 5-year period from 2014-2019. Of these, 45 had complete clinical history data necessary to analyze both LENT scores and post-op follow-up imaging. Of the 45 patients evaluated, 93.3% (42 patients) had either complete resolution of pleural effusions or partial resolution with an asymptomatic recovery within the first month post op. Chest pain was the most common postoperative complaint, which was present in 20% of patients. The mean postoperative ECOG score was 2±1.7. Patients with moderate to high-risk LENT scores had success rates of 96.7% and 92.3% respectively. Video-assisted thoracoscopic pleurodesis using Iodopovidone-iodine is an effective approach for MPEs. In developing countries where Iodopovidone iodine is readily available and affordable, patients may benefit from this agent with excellent results and minimal complications.
在滑石粉可能难以获取的发展中国家，电视辅助胸腔镜（VATS）碘伏胸膜固定术为治疗恶性胸腔积液（MPE）提供了一种极佳的替代方法。本研究分析了在哥伦比亚首都一家心胸中心使用VATS碘伏胸膜固定术治疗恶性胸腔积液的回顾性经验，根据LENT（乳酸、东部肿瘤协作组-美国东部肿瘤协作组体能状态评分、中性粒细胞-淋巴细胞比率、肿瘤类型）评分评估成功率。在2014年至2019年的5年期间，从我们的机构数据库中检索了75例接受VATS碘伏胸膜固定术治疗MPE的患者记录。其中，45例具有分析LENT评分和术后随访影像所需的完整临床病史数据。在评估的45例患者中，93.3%（42例）在术后第一个月内胸腔积液完全消退或部分消退且无症状恢复。胸痛是最常见的术后主诉，20%的患者出现胸痛。术后平均ECOG评分为2±1.7。中高风险LENT评分的患者成功率分别为96.7%和92.3%。使用碘伏-碘的电视辅助胸腔镜胸膜固定术是治疗MPE的有效方法。在碘伏-碘容易获取且价格可承受的发展中国家，患者可能会从这种药物中受益，效果极佳且并发症极少。
