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Disorders of the Pleura |

Relationship Between the Success of Bedside Pleurodesis and Pleural Elastance in Recurrent Malignant Pleural Effusion FREE TO VIEW

Pedro de Araujo, MD; Ricardo Terra, PhD; Rodrigo Chate, MD; Paulo Pêgo-Fernandes, PhD
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Thoracic Surgery, InCor, Sao Paulo, SP, Brazil


Chest. 2014;146(4_MeetingAbstracts):432A. doi:10.1378/chest.1992316
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Abstract

SESSION TITLE: Malignant Pleural Disease Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: To investigate the relationships between pleural elastance and the acumulation of effusion, clinical effectiveness, quality of life, dyspnea, pain and complications in patientes with recurrent malignant pleural effusions (RMPEs) treated with bedside pleurodesis.

METHODS: Prospective study including patients with RMPEs candidates for treatment with bedside pleurodesis recruited in our hospital between June 2009 and September 2013. Pleural elastance was measure after insertion of pleural catheter (14 Fr pigtail) and analysed after emptying of 800 ml (E800) and at the ending of the effusion drainage (Total Elastance, TE). The pleural volume on CT was measured after effusion drainage and one month after that. We used the difference between them to calculate the accumulation of effusion after the pleurodesis (radiological effectiveness, RE). Pleurodesis was considered successful when no additional pleural procedure was necessary. Life quality (analyzed in its various aspects), dyspnea and pain were evaluated before and 30 days after pleurodesis. Complications were registered and graded according to the CTCAE3.0.

RESULTS: A total of 119 patients were included. 39 were excluded (16 died before 30 days, 12 showed incomplete lung expansion, 5 had effusion with less than 800 ml and 6 did not return). 80 cases were analysed (61 female, 19 males, mean age 60.5 years). The median Karnofsky Performance Status index was 60. The primary neoplasm was breast in 40 patients, lung in 20, ovary in 9, colon, prostate, kidney and indeterminate in 2 and thyroid, stomach and pancreas in 1. We did not find significant correlation between E800 and RE (correlation coefficient -0,164, p=0,181) or TE and RE (correlation coefficient -0,215, p=0,74). There were no significant improvements in quality of life in every aspect reviewed. There were improvements in dyspnea and pain, but there were no significant correlation between both and E800 or RE. Successful pleurodesis was achieved in 71 patients (88.8%), but there were no significant correlation between it and E800 or TE. 5 patients had major complications and 8 had minor, there were no significant correlation between occurrence of major or minor complications and E800 or TE.

CONCLUSIONS: In this study, we did not find significant correlations between E800 or TE and radiological or clinical effectiveness of pleurodesis, quality of life, dyspnea, pain and complications.

CLINICAL IMPLICATIONS: Pleural elastance could not predict clinical or radiological outcomes of bedside pleurodesis.

DISCLOSURE: The following authors have nothing to disclose: Pedro de Araujo, Ricardo Terra, Rodrigo Chate, Paulo Pêgo-Fernandes

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