The Use of Single Incision Thoracoscopic Pleurectomy in the Management of Malignant Pleural Effusion

• Published in: Acta chirurgica belgica 2013-07, Vol.113 (4), p.270-274
• Main Authors: Kara, M., Alzafer, S., Okur, E., Halezeroglu, S.
• Format: Article
• Language: English
• Subjects: 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
• ISSN: 0001-5458
• DOI: 10.1080/00015458.2013.11680926

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.