Petrou M, Kaplan D, Goldstraw P
Royal Brompton National Heart and Lung Hospital, London.
Cancer. 1995 Feb 1;75(3):801-5. doi: 10.1002/1097-0142(19950201)75:3<801::aid-cncr2820750309>3.0.co;2-h.
Recurrent pleural effusions in patients with advanced cancer is a common problem that causes significant morbidity and can negatively affect patients' quality of life for their remaining months. Several palliative treatment options are available.
The results of a 10-year experience with 180 patients referred for the surgical palliation of their condition were retrospectively reviewed. Their mean age was 60 years (range, 20-90 years). One hundred and thirty-four patients (74%) had been treated before referral with one or more of the following modalities: repeated needle thoracocentesis (87 patients), tube thoracostomy (24 patients), chemical or biologic pleurodesis (22 patients), and pleurectomy (1 patient). One hundred and seventeen patients demonstrated full lung expansion at thoracoscopy/mini-thoracotomy and underwent talc pleurodesis, whereas the other 63 patients had the "trapped lung syndrome" and required the insertion of a pleuroperitoneal shunt (Denver, Biomedical, Inc).
There were no intraoperative deaths and the early death rate was 5.9% for the talc pleurodesis group and 3.2% for the group that received shunts. The mean hospital stay for the patients receiving talc and shunts was 7.3 days (range, 3-15 days) and 5.9 days (range, 2-12 days), respectively. Follow-up data were available in 60% of the patients and showed that effective palliation was achieved in more than 95% of patients in each group. There were eight patients (12%) with blocked shunts (five requiring replacement or renovation and three requiring removal and open drainage) at 1 week to 4 months after insertion. Two patients (one from each group) required one further episode of treatment by thoracocentesis. The median survival for the talc and shunt groups was 4.9 months (range, 1-36 months) and 5.4 months (range, 1-53 months). Patients with effusions because of secondary breast carcinoma or lymphomas survived the longest.
In patients with malignant pleural effusions in whom pleurodesis is precluded by limited lung expansion, effective palliation can be achieved by pleuro-peritoneal shunt insertion.
晚期癌症患者反复出现胸腔积液是一个常见问题，会导致严重的发病率，并可能对患者剩余数月的生活质量产生负面影响。有几种姑息治疗选择。
回顾性分析了180例因病情接受手术姑息治疗患者的10年经验结果。他们的平均年龄为60岁（范围20 - 90岁）。134例患者（74%）在转诊前接受过以下一种或多种治疗：反复胸腔穿刺抽液（87例）、胸腔闭式引流（24例）、化学或生物胸膜固定术（22例）以及胸膜切除术（1例）。117例患者在胸腔镜/小切口开胸手术时显示肺完全复张并接受了滑石粉胸膜固定术，而另外63例患者患有“肺被陷综合征”，需要插入胸膜腹膜分流管（丹佛生物医学公司）。
术中无死亡病例，滑石粉胸膜固定术组的早期死亡率为5.9%，接受分流管植入组为3.2%。接受滑石粉治疗和分流管植入的患者平均住院时间分别为7.3天（范围3 - 15天）和
