PURPOSE: The study was aim to analyze the results of pleurodesis for malignant pleural effusion for relief of dyspnea as palliative intervention performed by pulmonologist.
METHODS: Total of 163 patients with malignant pleural effusion underwent thoracoscopy for palliative pleurodesis. There were 93 males (57.05%) and 70 females (42.95%), aged between 44 to 94 years (mean age: 60.6 years). The effusion was right sided in 86 patients (52.7%) and left sided in 66 (40.49%), and bilateral in 11 (6.74%). Thoracoscopy was performed under local anesthesia with moderate sedation in all patients. Pleurodesis was done by instillation of tetracycline solution.
RESULTS: Pleurodesis was done in 151 cases. Duration of pleural drainage ranged between 1 and 11 days (mean: 3.64 days). No intraoperative mortality was noted. Two patients (1.2%) had surgical emphysema, 1 patient had re-expansion pulmonary edema (0.6 %) as post-operative complications. 6 (3.68%) cases underwent a bilateral pleurodesis. No pleurodesis was done in 12 cases because of non-expand (3.68%) and presence of multiple adhesions (3.68%). The 122 patients had regular follow up and mean follow-up period was 7.2 months. 10 patients had recurrences (8.19%), 6 of which were treated by repeat pleurodesis. The results were good in 134 patients (82.20%) and pleurodesis failure in 5 patients (3%).
CONCLUSIONS: Medical thoracoscopy for malignant pleural effusion have good success rate for pleurodesis with tetracycline as palliative treatment for dyspnea relief. It can be done under local anesthesia with moderate sedation by pulmonologist.
CLINICAL IMPLICATIONS: Thoracoscopic pleurodesis can be used as palliative therapy for dyspnea relief in malignant effusion.
DISCLOSURE: The following authors have nothing to disclose: Vikrant Deshmukh
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