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

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.

Keywords

• Dyspnea
• malignant pleural effusion
• pleurodesis
• uniportal VATS

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

Öz

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.

Anahtar Kelimeler

• Dispne
• malign plevral efüzyon
• plöredez
• uniportal VATS

Kaynakça

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