The use of single incision thoracoscopic pleurectomy in the management of malignant pleural effusion

Acta Chir Belg. Jul-Aug 2013;113(4):270-4. doi: 10.1080/00015458.2013.11680926.

Abstract

Background: A number of procedures have been used in the management of malignant pleural effusion including repeated thoracentesis, tube thoracostomy, drainage with catheter, chemical pleurodesis, pleurectomy and pleuro-peritoneal shunt. However, the optimal method of management remains unclear. On the other hand, single incision thoracoscopic surgery has been defined as a less invasive method than the standard threeportal videothoracoscopy. We herein present our series of patients who underwent single incision thoracoscopic pleurectomy for malignant pleural effusion.

Patients and methods: We performed a single incision thoracoscopic pleurectomy in a total of 19 consecutive patients, 11 (57.8%) male and 8 (42.2%) female with a mean age of 56.3 +/- 16.9 years who had malignant pleural effusions. We made a single 2-2.5 cm incision at the seventh or eighth intercostal spaces on the midaxillary line for the procedure.

Results: We performed a total of 23 single incision thoracoscopic total pleurectomies consisting of 11 (57.8%) right-sided, 4 (21.1%) left-sided and 4 (21.1%) bilateral procedures. The mean total postoperative drainage was 553 +/- 266 cc (Median; 470 cc), and the mean chest tube removal time was 2.3 +/- 0.4 days (Median; 2 days). We observed neither morbidity nor mortality. No patient required an additional port or a conversion to thoracotomy. Median follow-up was 83 days (range, 30 to 359 days). Pleural effusion recurred in two (8.6%) out of 23 procedures which resulted in a success rate as 91.4% for the procedure.

Conclusion: Single incision thoracoscopic pleurectomy is a safe, less invasive and an effective method of pleurodesis with a low recurrence rate in patients with malignant pleural effusion.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Drainage / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Pleural Effusion, Malignant / diagnosis
  • Pleural Effusion, Malignant / mortality
  • Pleural Effusion, Malignant / surgery*
  • Pleurodesis / methods*
  • Postoperative Period
  • Radiography, Thoracic
  • Survival Rate / trends
  • Thoracic Surgery, Video-Assisted / methods*
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Turkey / epidemiology
  • Young Adult