Postoperative outcome after palliative treatment of malignant pleural effusion.
indwelling pleural catheter
malignant pleural effusion
pleural carcinosis
pleurodesis
video-assisted thoracic surgery
Journal
Thoracic cancer
ISSN: 1759-7714
Titre abrégé: Thorac Cancer
Pays: Singapore
ID NLM: 101531441
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
revised:
23
05
2022
received:
21
04
2022
accepted:
25
05
2022
pubmed:
25
6
2022
medline:
5
8
2022
entrez:
24
6
2022
Statut:
ppublish
Résumé
The objective of this nationwide, registry-based study was to compare the two most frequently used procedures for the palliative treatment of a malignant pleural effusion (MPE) and to evaluate differentiated indications for these two procedures. This was a retrospective observational study based on data of the "PLEURATUMOR" registry of the German Society for Thoracic Surgery. Patients who were documented in the period from January 2015 to November 2021 and had video-assisted thoracic surgery (VATS) talc pleurodesis or implantation of an indwelling pleural catheter (IPC) were included. A total of 543 patients were evaluated. The majority suffered from secondary pleural carcinomatosis (n = 402; 74%). VATS talc pleurodesis (n = 361; 66.5%) was performed about twice as often as IPC implantation (n = 182; 33.5%). The duration of surgery was significantly shorter in IPC-patients with 30 min compared to VATS talc pleurodesis (38 min; p = 0.000). Postoperative complication rate was 11.8% overall and slightly higher after VATS talc pleurodesis (n = 49; 13.6%) than after IPC implantation (n = 15; 8.2%). After VATS talc pleurodesis patients were hospitalized significantly longer compared to the IPC group (6 vs. 3.5 days; p = 0.000). There was no significant difference in postoperative wound infections between the groups (p = 0.10). The 30-day mortality was 7.9% (n = 41). The implantation of an IPC can significantly shorten the duration of surgery and the hospital stay. For this reason, the procedure should be matched with the patient's expectations preoperatively and the use of an IPC should be considered not only in the case of a trapped lung.
Sections du résumé
BACKGROUND
The objective of this nationwide, registry-based study was to compare the two most frequently used procedures for the palliative treatment of a malignant pleural effusion (MPE) and to evaluate differentiated indications for these two procedures.
METHODS
This was a retrospective observational study based on data of the "PLEURATUMOR" registry of the German Society for Thoracic Surgery. Patients who were documented in the period from January 2015 to November 2021 and had video-assisted thoracic surgery (VATS) talc pleurodesis or implantation of an indwelling pleural catheter (IPC) were included.
RESULTS
A total of 543 patients were evaluated. The majority suffered from secondary pleural carcinomatosis (n = 402; 74%). VATS talc pleurodesis (n = 361; 66.5%) was performed about twice as often as IPC implantation (n = 182; 33.5%). The duration of surgery was significantly shorter in IPC-patients with 30 min compared to VATS talc pleurodesis (38 min; p = 0.000). Postoperative complication rate was 11.8% overall and slightly higher after VATS talc pleurodesis (n = 49; 13.6%) than after IPC implantation (n = 15; 8.2%). After VATS talc pleurodesis patients were hospitalized significantly longer compared to the IPC group (6 vs. 3.5 days; p = 0.000). There was no significant difference in postoperative wound infections between the groups (p = 0.10). The 30-day mortality was 7.9% (n = 41).
CONCLUSION
The implantation of an IPC can significantly shorten the duration of surgery and the hospital stay. For this reason, the procedure should be matched with the patient's expectations preoperatively and the use of an IPC should be considered not only in the case of a trapped lung.
Identifiants
pubmed: 35748347
doi: 10.1111/1759-7714.14534
pmc: PMC9346186
doi:
Substances chimiques
Talc
14807-96-6
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2158-2163Informations de copyright
© 2022 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.
Références
BMC Pulm Med. 2015 Mar 28;15:29
pubmed: 25887349
Eur Respir J. 2018 Jul 27;52(1):
pubmed: 30054348
Pneumologie. 2005 Feb;59(2):120-35
pubmed: 15724226
Thorac Cancer. 2022 Aug;13(15):2158-2163
pubmed: 35748347
J Thorac Dis. 2018 Jul;10(7):4659-4666
pubmed: 30174919
Am J Respir Crit Care Med. 2018 Oct 1;198(7):839-849
pubmed: 30272503
Respiration. 2013;85(1):36-42
pubmed: 23154202
Ann Thorac Med. 2017 Jan-Mar;12(1):3-10
pubmed: 28197215
Ann Intern Med. 1994 Jan 1;120(1):56-64
pubmed: 8250457
J Thorac Dis. 2015 Jun;7(6):1052-7
pubmed: 26150918
J Surg Res. 2018 Sep;229:134-144
pubmed: 29936980
Cochrane Database Syst Rev. 2020 Apr 21;4:CD010529
pubmed: 32315458
J Thorac Dis. 2015 Jun;7(6):1058-67
pubmed: 26150919
Chest. 2000 Jan;117(1):79-86
pubmed: 10631203
World J Surg Oncol. 2020 Jul 23;18(1):184
pubmed: 32703255
Ann Thorac Surg. 2012 Oct;94(4):1053-7; discussion 1057-9
pubmed: 22513274
Eur J Cardiothorac Surg. 2006 May;29(5):829-38
pubmed: 16626967
Cancer Manag Res. 2017 Jun 23;9:229-241
pubmed: 28694705
Chest. 2005 Mar;127(3):909-15
pubmed: 15764775
J Palliat Med. 2014 Jul;17(7):761-8
pubmed: 24773212
Ann Surg. 2004 Aug;240(2):205-13
pubmed: 15273542
Ann Am Thorac Soc. 2019 Jan;16(1):124-131
pubmed: 30272486
Dtsch Arztebl Int. 2013 May;110(18):313-8
pubmed: 23720697
Zentralbl Chir. 2008 Jun;133(3):218-21
pubmed: 18563684
J Natl Compr Canc Netw. 2012 Aug;10(8):975-82
pubmed: 22878823
Curr Opin Pulm Med. 2013 Jul;19(4):374-9
pubmed: 23673450
Ann Oncol. 2012 Aug;23(8):2006-2015
pubmed: 22345118
Acta Cytol. 1989 Nov-Dec;33(6):911-6
pubmed: 2588923
BMJ Support Palliat Care. 2020 Mar;10(1):45-54
pubmed: 31243020
Thorax. 2010 Aug;65 Suppl 2:ii32-40
pubmed: 20696691
BMJ Open Respir Res. 2016 Feb 05;3(1):e000123
pubmed: 26870384
Cochrane Database Syst Rev. 2016 May 08;(5):CD010529
pubmed: 27155783