DIE EFFEKTIVE BEHANDLUNG DES MALIGNEN PLEURAERGUSSES : THORAKOSKOPISCHE TALKUMPLEURODESE - PLEUROPERITONEALER SHUNT

BASIC PROBLEM: Definitive palliation of malignant pleural effusion demands a therapeutic procedure that is efficient with a low risk of complication and death. This study was undertaken to evaluate the outcome of thoracoscopic talcum pleurodesis (TTP), with insertion of pleuro-peritoneal shunt (PPS) for permanent drainage, if indicated. PATIENTS AND METHODS: The results of treating malignant pleural effusions were analysed retrospectively in 36 patients (15 men, 21 women; mean age 65 [48-89] years) who had undergone 37 video-assisted TTP and 6 PPS. RESULTS: TTP achieved significant improvement of dyspnoea in 89% of patients and PPS succeeded in providing permanent internal drainage even in cases of adherent pleura. CONCLUSION: Video-assisted TTP is the method of choice in the palliative treatment of malignant pleural effusions in the still expanding lung. In case of an adherent nonexpanding lung PPS provides effective and permanent palliation.