Author/Editor		Turel, Matjaž; Debeljak, Andrej; Kecelj, Peter
Title		Torakoskopska plevrodeza s smukcem pri malignem plevralnem izlivu
Translated title		Thoracoscopic talc pleurodesis for malignant pleural effusion
Type		članek
Source		Endoskopska Revija
Vol. and No.		Letnik 3, št. 7
Publication year		1998
Volume		str. 189-95
Language		slo
Abstract		Background. The objective of the study was to determine the effectiveness of thoracoscopic talc pleurodesis to control malignant pleural effusion (MPE). Patients and methods. Our retrospective study involved 25 consecutive patients, 9 with mesothelioma and 16 with secondary MPE, treated at this Department between July, 1,1994 and December 31, 1997. There were 19 men and 6 women, ranging in age from 42 to 72 years (mean 61.8 +- 8.6 yrs). The outcome variables studied included effectiveness of pleurodesis, complication rate, duration of thoracic drainage, post-procedure hospital stay, quality of life and survival following discharge from the hospital. Results. Pleurodesis was successfully performed in 21 patients (84%). The complications included empyema in one woman and growth of the mesothelioma through the thoracosope entry incision in one man. One patient was operated on 10 days after unsuccessful thoracoscopic pleurodesis. Mechanical pleurodesis was attempted, but the patient succumbed perioperatively to sudden cardiac death. The durationof thoracic drainage ranged from 1 to 28 days (mean 4.6 +- 5.4 days). After the procedure, the patients stayed in the hospital for 3 to 32 days (mean 10.3 +- 6.6 days). The quality of life was good in 1 patient, satisfactory in 9 patients, poor in 7 and very poor in 7 patients. The duration of survival was significantly longer in patients with mesothelioma than in patients with secondary MPE (12.5 +- 9.8 vs. 5.8 +- 5.6 months; p<0.05). Conclusions. Thoracoscopic talc pleurodesis has proved an effective method to control recurrent malignant pleural effusion in our patients.
Summary		Izhodišča. Želeli smo ugotoviti uspešnost torakoskopske plevrodeze s smukcem pri naših bolnikih z malignim plevralnim izlivom (MPI). Bolniki in metode. V retrospektivno analizo smo vključili 25 bolnikov (9 z mezoteliomom in 16 s sekundarnim MPI), ki smo jim opravili torakoskopsko plevrodezo s smukcem med 1. julijem 1994 31. decembrom 1997. Med njim je bilo 19 moških in 6 žensk. Stari so bili od 42 do 72 (povprečno 61.8 +- 8.6). Ugotavljali smo uspešnost plevrodeze, zaplete v zvezi s posegom trajanje torakalne drenaže, čas do odpusta iz bolnišnice po posegu, kakovost življenja po odpustu in preživetje po posegu. Rezultati. Metoda je bila uspešna pri 21 bolnikih (84%). Od zapletov v zvezi s posegom smo zabeležili razrast mezotelioma v vstopni kanal torakoskopa pri enem bolniku in empiem pri eni bolnici. En bolnik je bil 10 dni po neuspešni torakoskopski plevrodezi operiran. Opravljena je bila mehanična plevrodeza. Bolnik je zaradi odpoved srca na dan posega umrl. Torakalna drenaža je trajala od 1 do 28 (povprečno 4.6 +- 5.4) dni po posegu. Bolniki so bili odpuščeni med 3 in 32 (povprečno 10.3 +- 6.6). dnem po posegu. Po odpustu je zelo slabo živelo 7 bolnikov, slabo 7, dobro 9 in zelo dobro 1 bolnik. Preživetje bolnikov z mezoteliomom je bilo statistično pomembno daljše kot preživetje bolnikov v skupin bolnikov s sekundarnim MPI (12.5 +- 9.8 proti 5.8 +- 5.6 mesecev; p<0.05). Zaključki. Ocenjujemo, da je torakoskopska plevrodeza s smukcem tudi pri naših bolnikih učinkovita metoda za preprečevanje ponavljajočih se plevralnih izlivov, ki so posledica malignega mezotelioma ali zasevkov raka v plevro.
Descriptors		PLEURAL EFFUSION, MALIGNANT PLEURODESIS THORACOSCOPY TALC SURVIVAL ANALYSIS TREATMENT OUTCOME