Early Video-Assisted Thoracic Surgery (VATS) improves quality of life In complicated Neoplastic Pleural Effusions.

Abstract

Introduction: Malignant pleural effusion (MPE) involves advanced cancer disease. Pleural biopsy for endoscopic thoracic surgery allows diagnosis in more than 90% of cases and instrumentation of the pleural space, improving the results of the technique.Material and Method: We performed a retrospective analysis of patients with MPE who underwent a talc chemical pleurodesis. Two groups were formed, one with complicated malignant pleural effusion (CMPE) and another with uncomplicated malignant pleural effusion (NCMPE). In the group with CMPE, "release - expansion maneuvers" were performed. The variables between the two groups were compared for the relevant analysis.Results: We analyzed 28 patients with MPE treated with chemical pleurodesis by endoscopic thoracic surgery. The average age was 62.64 years. Pleural involvement due to breast disease was the most frequent form (46.4%). There was no difference between complication rate (p = 0.31) and the risk of death at 30 days (p = 1.09) with aggressive management of pleural space. The delay pleurodesis indication was related to a higher rate of complications (p = 0.002) and a higher probability of death within 30 days (p = 0.008). The majority of patients return to their daily tasks, with good tolerance to dyspnea following the procedure.Conclusion: In patients with complicated MPE, the "lung-release maneuvers" described above would increase the chances of improving outcomes at low risk. Early chemical pleurodesis improves the quality of life of patients with PND.

Keywords

• Derrame pleural maligno, Toracoscopía, Cirugía asistida por video