Introduction
Malignant Pleural Effusion (MPE) is a common terminal clinical problem in patients with advance cancer. Treatment options for MPE include observation, thoracocentesis, or pleurodesis. In the current study, we compared the effectiveness and safety of combined mechanical and chemical pleurodesis by Video Assisted Thoracoscopic Surgery (VATS) with chemical pleurodesis via intercostals tube alone, using talc as pleurodesis agent in both.
Material and methods
In this prospective study, diagnosed patients of MPE having Eastern Cooperative Oncology Group (ECOG) performance score 3 or less 3, expected life expectancy of more than 3 months, and having lung re-expansion after drainage were selected for pleurodesis. Patients with ability to undergo general anesthesia were considered for VATS assisted combined mechanical & chemical pleurodesis (Group A). In the remaining chemical pleurodesis was performed at bedside (Group B).
Results
The duration of this study was 1 year. The total number of patients was 30. There were 15 patients each in both the groups. Pleurodesis was achieved in 4.47 ± 0.92 days in group A and 6.33 ± 0.90 days in group B. This difference was highly significant (p < 0.0001). Post procedural complaints were more or less same in both the groups.
Conclusion
Combined mechanical and chemical pleurodesis (VATS assisted) appears to be superior to chemical pleurodesis, as it offers less morbidity, lesser hospital stay, and complete response in follow up. This modality may be used in patients of MPE for palliation, who are fit for general/ regional anesthesia.