Onkologie. 2014:8(1):35-38

Thoracoscopic chemically induced pleurodesis in the treatment of malignant pleural effusion

Petr Habal¹, Nedal Omran¹, Karolina Jankovičová², Kateřina Kondělková², Jan Krejsek², Jiří Manďák¹

¹ Kardiochirurgická klinika, Univerzita Karlova v Praze, LF a FN v Hradci Králové

² Ústav klinické imunologie a alergologie, Univerzita Karlova v Praze, LF a FN v Hradci Králové

Continuous pleural effusion production of any aetiology can significantly affect the quality of patients life. Chronic effusion accumulation

in the pleural cavity can lead to lung parenchyma compression. The first symptom of this entity is a progressive exertional dyspnea, which

can later turn in dyspnea at rest. With the increase of the pleural effusion volume, pulmonary atelectasis can develop due to chronic parenchycha

compression. The patient is at risk of inflamatory complications from the territory of non-ventilated parenchyma. Patients with

a diagnosis of malignant disease have this risk considerably higher due to their previous chemotherapy or radiation, which substantially

affect the immunity system. Repeated pleural effusion formation can significantly take part in the development of the terminal status of

cancer cachexia. An effective method of palliative treatment is a chemical pleurodesis, which is used in selected patients. The principle

is inducing aseptic inflammation. The most effective way of application is via videothoracoscopy. In a group of 47 patients, there were

29 (61.7 %) men and 18 (38.3 %) women with cytologically diagnosed recurrent malignant pleural. The age ranged between 42 and 80

with average age of 65 years. The aim was to assess the course of local and systemic inflammatory changes after talc application. The

effect of treatment was not influenced by the type of malignancy . In both groups there was no significant difference in postoperative

complications. This proves the safety of the selected procedure and also supports the correctness of the chosen algorithm of treatment.

Keywords: malign pleural effusion, thoracoscopy, talc poudrage, sCD-163

Published: March 1, 2014  Show citation