Mohamad Jailaini Mas Fazlin, Azmel Azat Azrai, Mohd Zain Mohd Zulkifli, Abdul Hamid Mohamed Faisal
Respiratory Unit Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia.
Endoscopy Services Centre Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia.
Respirol Case Rep. 2025 Sep 2;13(9):e70331. doi: 10.1002/rcr2.70331. eCollection 2025 Sep.
Management of malignant pleural effusion (MPE) via medical thoracoscopy presents a clinical challenge, particularly when deciding whether to proceed with talc poudrage during the same setting. This decision is often complicated by uncertainty about lung re-expansion and the potential failure of pleurodesis. We describe a series of three patients with cancer-associated MPE who underwent medical thoracoscopy with talc poudrage combined with indwelling pleural catheter (IPC) insertion. This combined approach served as a practical and effective strategy, offering immediate symptom relief, facilitating early pleural symphysis when feasible, and providing a reliable fallback option in cases of non-expanding lung. The dual-modality technique highlights a safe, flexible pathway for managing MPE with improved procedural confidence and patient-centred outcomes. We report 3 cases of MPE successfully achieving pleurodesis with a combination of talc poudrage and IPC, resulting in removal of IPC on follow-up.
通过内科胸腔镜治疗恶性胸腔积液（MPE）是一项临床挑战，尤其是在决定是否在同一操作过程中进行滑石粉喷洒时。这一决定往往因肺复张的不确定性和胸膜固定术可能失败而变得复杂。我们描述了3例癌症相关MPE患者，他们接受了内科胸腔镜检查，同时进行滑石粉喷洒和留置胸膜导管（IPC）插入。这种联合方法是一种实用且有效的策略，可立即缓解症状，在可行时促进早期胸膜粘连，并在肺不张的情况下提供可靠的备用选择。这种双模式技术为管理MPE提供了一条安全、灵活的途径，提高了操作信心并改善了以患者为中心的治疗效果。我们报告了3例MPE患者通过滑石粉喷洒和IPC联合成功实现胸膜固定术的病例，随访时IPC得以拔除。
