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Title: Video-assisted thoracoscopic (VATS) pleurodesis for malignant effusion: an Australian teaching hospital's experience.
Austin Authors: Trotter, Dean;Aly, Ahmad ;Siu, Lyndon;Knight, Simon R 
Affiliation: Austin Hospital, Melbourne, Australia
Issue Date: 1-Jun-2005
Publication information: Heart, Lung & Circulation; 14(2): 93-7
Abstract: Video-assisted thoracoscopic surgery (VATS) is commonly employed to achieve pleurodesis in patients suffering malignant pleural effusion (MPE). AIMS.: To evaluate the utility and outcome of VATS pleurodesis in management of MPE.Two hundred and two consecutive VATS pleurodesis for MPE were evaluated. Data was derived from a prospectively maintained database and hospital records. Pleurodesis was deemed unsuccessful if a significant effusion occurred within 30 days of surgery.VATS pleurodesis was successful in 88% of patients (failure 12%) while recurrence of effusion occurred in 18%. Post-operative air space, air leak, empyema and prolonged intercostal catheter drainage (>14 days) were all significantly associated with a failed procedure. Mean length of stay was 10.4 days and 42% of patients were discharged within 7 days of surgery. Morbidity was 20% with no operative deaths and median survival was 94 days. Inpatient mortality was 5%. High ASA (>or=4) was significantly associated with increased risk of inpatient death (p<0.001) and poorer long-term survival (43 days versus 133 days, p=0.05).VATS pleurodesis offers reasonable palliation of MPE with low morbidity and rapid recovery. Patients with an ASA score of >or=4 have a poor overall outcome and warrant less invasive palliative measures.
Gov't Doc #: 16352262
DOI: 10.1016/j.hlc.2005.02.004
Type: Journal Article
Subjects: Adult
Aged, 80 and over
Hospitals, Teaching
Length of Stay
Middle Aged
Pleural Effusion, Malignant.therapy
Prospective Studies
Retrospective Studies
Thoracic Surgery, Video-Assisted
Treatment Outcome
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