Videothoracoscopic collagen pleurodesis in malignant pleurisy

Abstract

The study was aimed to develop a method of videothoracoscopic collagen pleurodesis in malignant pleurisy and to evaluate its efficacy.

The article presents results of treatment of 24 patients with recurrent malignant pleurisy underwent videothoracoscopic collagen pleurodesis. Twenty patients were diagnosed non-small cell lung carcinoma and 4 ones were with breast cancer. The operative intervention included videothoracoscopic revision of the pleural cavity under the endotracheal anesthesia, pleura biopsy, evacuation of fluid, pulverization of powdered collagen (1 g), and drainage of the pleural cavity. Videothoracoscopy allowed macroscopic detection of pleural carcinomatosis in 100 % of the patients. Target histological examination of the biopsy samples determined a histological type of tumor in all the patients. All the cases showed a positive therapeutic clinical and radiological effect which was complete solution of the pleural effusion. Eighteen of 24 patients (75 %) did not have delayed relapses of the pleural effusion, need of thoracocentesis and evacuation of the fluid. We evaluated immediate and delayed results, survival and quality of life of the patients.

Conclusion. Videothoracoscopic collagen pleurodesis is a simple and quite effective method of palliative treatment of patients with malignant pleurisy improving their quality of life.