Thorac Cardiovasc Surg 2006; 54(5): 332-336
DOI: 10.1055/s-2006-923931
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Malignant Pleural Effusion Treatment Outcomes: Pleurodesis via Video-Assisted Thoracic Surgery (VATS) Versus Tube Thoracostomy

S.-P. Luh1 , C.-Y. Chen2 , C.-Y. Tzao3
  • 1Cardiothoracic Surgery, Tzu-Chi General Hospital, Taipei, Taiwan
  • 2Thoracic Surgery, Chinese Medical University Hospital, Taichung, Taiwan
  • 3Thoracic Medicine, Tzu-Chi General Hospital, Taipei, Taiwan
Further Information

Publication History

Received October 11, 2005

Publication Date:
10 August 2006 (online)

Abstract

Study Objectives: Video-assisted thoracic surgery (VATS) has been widely used in the diagnosis and management of various thoracic diseases. The objective of this retrospective study was to compare the effectiveness of patients undergoing pleurodesis through VATS versus tube thoracostomy for malignant pleural effusion (MPE). Study design was a retrospective review of patients treated in medical centers and hospitals in Taiwan. Patients: One hundred and forty-eight patients with MPE resistant to systemic therapy resulting from various types of carcinomas were retrospectively reviewed. VATS pleurodesis was carried out in 82 and tube thoracostomy with pleurodesis in 66 patients. Results: There were no intraoperative deaths and 4 (2.7 %) in-hospital deaths. One hundred and eighteen (79.7 %) patients were available for follow-up. There were no statistically significant differences in the preoperative characteristics of the two treatment groups, except that the amount of effusion and the percentage of patients with dyspnea were both higher in the VATS treatment group. The duration of chest tube drainage was significantly longer (p < 0.01) in the tube thoracostomy treatment group (9.1 ± 3.3 vs. 6.2 ± 2.3 days). There were no significant differences between the treatment groups with regard to the incidence of surgical complications and perioperative mortality. Median survival was similar in both treatment groups; however, the VATS treatment group had a significantly longer median recurrence-free survival than the tube thoracostomy treatment group. Conclusions: VATS treatment for MPE appears to be superior to tube thoracostomy for diagnostic accuracy and effectiveness in preventing effusion recurrence; however, the role of these treatments for MPE is palliative, and does not significantly prolong survival time.

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Prof. Shing-Ping Luh

Thoracic Medicine
Tzu-Chi General Hospital
Cardiothoracic Surgery

No. 20, Lane 199, Sec 2, Ba-De Rd, Chung-Shan District

Taipei

Taiwan 104, Repuplic of China

Phone: + 886289125971

Fax: + 88 62 89 12 59 71

Email: luh572001@yahoo.com.tw