Founded in 1993
  Year: 2001 | Volume: 9 | Issue: 1 | Pages: 3-7
  Original Article
  PLEURAL EFFUSIONS OF MALIGNANT ETIOLOGY: DIAGNOSTICS, TREATMENT AND QUALITY OF LIFE
Milos KOLEDIN, Dejan DJURIC, Aleksandar MILOVANCEV, Milorad BIJELOVIC, Borislav BAROS
  DOI:
  Abstract:
  Background: Pleural effusions of malignant etiology develop in the terminal stage of a malignant disease. They induce a further deterioration of a patient's bad general health condition, making him hospital ridden due both to his serious general state and the need for successive pleural aspirations. It is crucial to define the etiology of a pleural effusion and perform pleurodesis in the most effective, comfortable and humane way for a patient. Among the variety of pleurodesis agents having been used worldwide so far, talc has emerged as the most efficient, the safest and low cost pleurodesis agent.
Methods: In period 1992-2000, pleurodesis was performed in 317 patients with a malignant pleural effusion at the Thoracic Surgery Clinic in Sremska Kamenica. The talc suspension was introduced intrapleurally throuh a thoracic drain after the effusion had been completely evacuated. The patients in whom the cytological analysis of the pleural puncture sample failed to enlighten the etiology of the effusion were submitted to thoracoscopy. Pleurodesis is considered effective if no relapse occurs within 3 months after the intervention.
Results: Pleurodesis was assessed as effective in 310 patients of our series (98%). The mean duration of the pleural drainage was 5.4 days. Regarding complications, we had fever, pain and separation of the effusion. No deaths were induced by the procedure of pleurodesis itself. Afterwards the patients came for an ambulatory follow-up until they died.
Conclusion: In our opinion, talc pleurodesis is the most effective, humane, the cheapest and safest method for obliterating the pleural space in malignant pleural effusions. The method has the efficacy of over 95%. Thoracoscopy, as well as pleurodesis have a low risk of complications. The quality of life in these patients is significantly improved 30 days after pleurodesis since the majority of the symptoms either completely disappeared, or their intensity decreased a lot, regarding in particular suffocation, cough and pain as the major symptoms in these patients.
  Key words: Pleural Effusion, Malignant+diagnosis+therapy; Pleurodesis; Thoracic Surgery, Video-Assisted
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Founder, owner and publisher: Oncology Institute of Vojvodina, Serbia
Online since 1997 (Abstracts only); 2000 (Abstracts and Full text)
ISSN: 0354-7310 eISSN: 1450-9520