Research Article
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Malign Plevral Efüzyonların Tedavisinde Uniportal Video Yardımlı Torakoskopik Talk Plöredezis. Erken Dönem Talk Plöredezis Daha Etkili midir?

Year 2023, Volume: 8 Issue: 3, 375 - 381, 06.09.2023
https://doi.org/10.26453/otjhs.1315767

Abstract

Amaç: VATS talk plöredezis malign plevral efüzyonun (MPE) palyatif tedavisinde etkili bir yöntemdir. Bu çalışmada erken ve geç faz talk plöredez prosedürlerinin karşılaştırılması ve uniportal VATS talk plöredez prosedürünün başarısını etkileyen faktörlerin belirlenmesi amaçlanmıştır.
Materyal ve Metot: MPE nedeniyle Uniportal VATS talk plöredezis uygulanan 58 hastanın verileri retrospektif olarak incelendi. Hastalar erken dönem talk plörodezis grubu (n=23, %48,3) ve geç dönem talk plörodezis grubu (n=25, %51,7) olarak ikiye ayrıldı. Gruplar Pearson ki-kare testi ve Mann-Whitney U testleri kullanılarak karşılaştırıldı.
Bulgular: Komplikasyon 10 hastada (17,2%) gelişti. Erken dönem Uniportal VATS talk plöredezis yapılan grup ile geç dönem Uniportal VATS plöredezis yapılan grup arasında komplikasyon oranı (p=0,905), hastanede kalış süresi (p=0,821) açısından istatistiksel fark saptanmadı (p=0,900). Erken dönemde talk plöredezis prosedürünün geç dönem talk prosedürüne göre daha yüksek başarı gösterdiği görüldü (Odds ratio=1,425, 95%CI=0,307-6,624), fakat istatistiksel olarak anlamlı değildi (p=0,060). Erken dönem talk plöredezis uygulanan hastaların %86'sının ilk 3 ay içinde MPE nedeniyle hastaneye tekrar başvurusu olmadığı belirlendi.
Sonuç: Uniportal VATS talk plöredezis malign plevral efüzyonlarda komplikasyon oranı düşük, başarı oranı yüksek, güvenli ve etkili bir tedavi yöntemidir. Erken dönemde uygulanan talk plöredezis prosedürü tekrarlayan hastane yatışlarını önemli ölçüde azaltmaktadır.

Supporting Institution

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Project Number

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References

  • Bibby AC, Dorn P, Psallidas I, et al. ERS/EACTS statement on the management of malignant pleural effusions. Eur J cardio-thoracic Surg. 2019;55(1):116-132.
  • Hughes SM, Carmichael JJ. Malignant Pleural Effusions: Updates in Diagnosis and Management. Life. 2023;13(1):115. doi:10.3390/life13010115
  • Awadallah SF, Bowling MR, Sharma N, Mohan A. Malignant pleural effusion and cancer of unknown primary site: a review of literature. Ann Transl Med. 2019;7(15):353. doi:10.21037/atm.2019.06.33
  • Dipper A, Jones HE, Bhatnagar R, Preston NJ, Maskell N, Clive A. Interventions for the management of malignant pleural effusions: an updated network meta-analysis. Eur Respir Rev. 2021;30(160):210025. doi:10.1183/16000617.0025-2021
  • Cobanoglu U, Kemik O, Celik S, Sayir F. A novel approach for preventing recurrence of malign pleural effusion: early phase pleurodesis. Arch Med Sci. 2018;14(6):1404-1415.
  • Pochettino F, Visconti G, Godoy D, et al. Association between Karnofsky performance status and outcomes in cancer patients on home parenteral nutrition. Clin Nutr ESPEN. 2023;54:211-214.
  • Chiang K, Ho JC, Chong P, et al. Role of early definitive management for newly diagnosed malignant pleural effusion related to lung cancer. Respirology. 2020;25(11):1167-1173.
  • Zhang Y, Wang J, Liang B, Wu H, Chen Y. Diagnosis of malignant pleural effusion with combinations of multiple tumor markers: A comparison study of five machine learning models. Int J Biol Markers. 2023:38(2):139-146. doi:10.1177/03936155231158125
  • Taghizadeh N, Fortin M, Tremblay A. US hospitalizations for malignant pleural effusions: data from the 2012 national inpatient sample. Chest. 2017;151(4):845-854.
  • Feller-Kopman D, Light R. Pleural disease. N Engl J Med. 2018;378(8):740-751.
  • Cheng C, Yang Y, Yang W, Wang D, Yao C. The diagnostic value of CEA for lung cancer-related malignant pleural effusion in China: a meta-analysis. Expert Rev Respir Med. 2022;16(1):99-108. doi:10.1080/17476348.2021.1941885
  • Beltsios ET, Mavrovounis G, Adamou A, Panagiotopoulos N. Talc pleurodesis in malignant pleural effusion: a systematic review and meta-analysis. Gen Thorac Cardiovasc Surg. 2021;69:832-842.
  • Ost DE, Niu J, Zhao H, Grosu HB, Giordano SH. Quality gaps and comparative effectiveness of management strategies for recurrent malignant pleural effusions. Chest. 2018;153(2):438-452.
  • Cardillo G, Facciolo F, Carbone L, et al. Long-term follow-up of video-assisted talc pleurodesis in malignant recurrent pleural effusions. Eur J Cardio-Thoracic Surg. 2002;21(2):302-306.
  • Zhang W, Zhao Y, Li S, Zhao Y, Guo N, Liu B. Complications of thoracoscopic talc insufflation for the treatment of malignant pleural effusions: a meta-analysis. J Cardiothorac Surg. 2021;16(1):1-8.
  • Rodriguez-Panadero F, Montes-Worboys A. Mechanisms of pleurodesis. Respiration. 2012;83(2):91-98.
  • Nosotti M, Mazzucco A, Daffrè E, Cattaneo M, Ferrari M, Mendogni P. Video assisted Thoracoscopy in the diagnosis and treatment of malignant pleural diseases. J Xiangya Med. 2020;5(27):1-7. doi:10.21037/jxym-20-52
  • Barbetakis N, Asteriou C, Papadopoulou F, et al. Early and late morbidity and mortality and life expectancy following thoracoscopic talc insufflation for control of malignant pleural effusions: a review of 400 cases. J Cardiothorac Surg. 2010;5(1):1-7.
  • Markowiak T, Ried M, Großer C, et al. Postoperative outcome after palliative treatment of malignant pleural effusion. Thorac Cancer. 2022;13(15):2158-2163.
  • Leemans J, Dooms C, Ninane V, Yserbyt J. Success rate of medical thoracoscopy and talc pleurodesis in malignant pleurisy: A single‐centre experience. Respirology. 2018;23(6):613-617.

Uniportal Video-assisted Thoracoscopic Talc Pleurodesis in the Treatment of Malignant Pleural Effusions. Is Early Phase Talc Pleurodesis More Effective?

Year 2023, Volume: 8 Issue: 3, 375 - 381, 06.09.2023
https://doi.org/10.26453/otjhs.1315767

Abstract

Objective: VATS talk pleurodesis is an effective method for palliatively treating malignant pleural effusion (MPE). This study aimed to compare early and late-phase talc pleurodesis procedures and to determine the factors affecting the success of the uniportal VATS talc pleurodesis procedure.
Materials and Methods: The data of 58 patients who underwent uniportal VATS talc pleurodesis due to MPE were analysed retrospectively. The patients were divided into two groups as early-phase talc pleurodesis (n=23, 48.3%) and late-phase (n=25, 51.7%). Groups were compared using Pearson chi-square test and Mann-Whitney U tests.
Results: Complications developed in 10 patients (17.2%). No significant difference was found between the early-phase talc pleurodesis and the late-phase pleurodesis regarding complication rate (p=0.905), durations of hospitalisation (p=0.821). It was observed that the early-phase talc pleurodesis procedure had higher success than the late-phase talc pleurodesis procedure (Odds ratio=1.425, 95%CI=0.307-6.624), although not statistically significant (p=0.06). It was determined that 86% of the patients who underwent early talc pleurodesis had no hospital readmission due to MPE within the first 3 months.
Conclusion: Uniportal VATS talc pleurodesis is a safe and effective treatment method for malignant pleural effusion, with low complication and high success rates. Early-phase talc pleurodesis procedure significantly reduces recurrent hospitalisations.

Project Number

yok.

References

  • Bibby AC, Dorn P, Psallidas I, et al. ERS/EACTS statement on the management of malignant pleural effusions. Eur J cardio-thoracic Surg. 2019;55(1):116-132.
  • Hughes SM, Carmichael JJ. Malignant Pleural Effusions: Updates in Diagnosis and Management. Life. 2023;13(1):115. doi:10.3390/life13010115
  • Awadallah SF, Bowling MR, Sharma N, Mohan A. Malignant pleural effusion and cancer of unknown primary site: a review of literature. Ann Transl Med. 2019;7(15):353. doi:10.21037/atm.2019.06.33
  • Dipper A, Jones HE, Bhatnagar R, Preston NJ, Maskell N, Clive A. Interventions for the management of malignant pleural effusions: an updated network meta-analysis. Eur Respir Rev. 2021;30(160):210025. doi:10.1183/16000617.0025-2021
  • Cobanoglu U, Kemik O, Celik S, Sayir F. A novel approach for preventing recurrence of malign pleural effusion: early phase pleurodesis. Arch Med Sci. 2018;14(6):1404-1415.
  • Pochettino F, Visconti G, Godoy D, et al. Association between Karnofsky performance status and outcomes in cancer patients on home parenteral nutrition. Clin Nutr ESPEN. 2023;54:211-214.
  • Chiang K, Ho JC, Chong P, et al. Role of early definitive management for newly diagnosed malignant pleural effusion related to lung cancer. Respirology. 2020;25(11):1167-1173.
  • Zhang Y, Wang J, Liang B, Wu H, Chen Y. Diagnosis of malignant pleural effusion with combinations of multiple tumor markers: A comparison study of five machine learning models. Int J Biol Markers. 2023:38(2):139-146. doi:10.1177/03936155231158125
  • Taghizadeh N, Fortin M, Tremblay A. US hospitalizations for malignant pleural effusions: data from the 2012 national inpatient sample. Chest. 2017;151(4):845-854.
  • Feller-Kopman D, Light R. Pleural disease. N Engl J Med. 2018;378(8):740-751.
  • Cheng C, Yang Y, Yang W, Wang D, Yao C. The diagnostic value of CEA for lung cancer-related malignant pleural effusion in China: a meta-analysis. Expert Rev Respir Med. 2022;16(1):99-108. doi:10.1080/17476348.2021.1941885
  • Beltsios ET, Mavrovounis G, Adamou A, Panagiotopoulos N. Talc pleurodesis in malignant pleural effusion: a systematic review and meta-analysis. Gen Thorac Cardiovasc Surg. 2021;69:832-842.
  • Ost DE, Niu J, Zhao H, Grosu HB, Giordano SH. Quality gaps and comparative effectiveness of management strategies for recurrent malignant pleural effusions. Chest. 2018;153(2):438-452.
  • Cardillo G, Facciolo F, Carbone L, et al. Long-term follow-up of video-assisted talc pleurodesis in malignant recurrent pleural effusions. Eur J Cardio-Thoracic Surg. 2002;21(2):302-306.
  • Zhang W, Zhao Y, Li S, Zhao Y, Guo N, Liu B. Complications of thoracoscopic talc insufflation for the treatment of malignant pleural effusions: a meta-analysis. J Cardiothorac Surg. 2021;16(1):1-8.
  • Rodriguez-Panadero F, Montes-Worboys A. Mechanisms of pleurodesis. Respiration. 2012;83(2):91-98.
  • Nosotti M, Mazzucco A, Daffrè E, Cattaneo M, Ferrari M, Mendogni P. Video assisted Thoracoscopy in the diagnosis and treatment of malignant pleural diseases. J Xiangya Med. 2020;5(27):1-7. doi:10.21037/jxym-20-52
  • Barbetakis N, Asteriou C, Papadopoulou F, et al. Early and late morbidity and mortality and life expectancy following thoracoscopic talc insufflation for control of malignant pleural effusions: a review of 400 cases. J Cardiothorac Surg. 2010;5(1):1-7.
  • Markowiak T, Ried M, Großer C, et al. Postoperative outcome after palliative treatment of malignant pleural effusion. Thorac Cancer. 2022;13(15):2158-2163.
  • Leemans J, Dooms C, Ninane V, Yserbyt J. Success rate of medical thoracoscopy and talc pleurodesis in malignant pleurisy: A single‐centre experience. Respirology. 2018;23(6):613-617.
There are 20 citations in total.

Details

Primary Language English
Subjects Thoracic Surgery
Journal Section Research article
Authors

Yunus Aksoy 0000-0003-4966-2809

Abidin Sehitogulları 0000-0002-4897-4205

Project Number yok.
Early Pub Date August 30, 2023
Publication Date September 6, 2023
Submission Date June 16, 2023
Acceptance Date August 8, 2023
Published in Issue Year 2023 Volume: 8 Issue: 3

Cite

AMA Aksoy Y, Sehitogulları A. Uniportal Video-assisted Thoracoscopic Talc Pleurodesis in the Treatment of Malignant Pleural Effusions. Is Early Phase Talc Pleurodesis More Effective?. OTJHS. September 2023;8(3):375-381. doi:10.26453/otjhs.1315767

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