Material and Methods: The records of 71 patients who had diagnosed MPE between 1996 and 2000 were reviewed retrospectively. Thirty-eight of the cases were male, and the mean age of all patients was 55±12,8 (ranged between 27-83). Bronchogenic cancer in 28 cases (39,4%) and malignant mesothelioma in 17 (%23,9) cases were leading etiologies. Ttreatment procedures performed were tube thoracostomy (n=36), VATS (n=18 ), thoracotomy (n=7) and Pleuperitoneal Shunt (PPS) (n=11).
Results: The success rates of peurodesis were 93%, 62%, and 66% with talc, tetracyclin and bleomycin respectively. Talc was found to be superior to teracyclin and bleomycin (p=0,026). Eight of 36 cases (22%) who had pleurodesis with tube thoracosotomy had recurrence in a month. Whilst none of the patinets with VATS and pleurodesis had recurrence. Besides the duration of drainage was significantly shorter in VATS group than in tube thoracostomy (p=0,036). No complications occured in cases who had PPS. The median survival of all patients was 5,9±4,2 (1-20) months.
Conclusion: Tube thoracostomy and pleurodesis is an effective, cheap and easy way of treating patients who already had the diagnosis of MPE. In patients without a diagnosis VATS is extremely useful in establishing the diagnosis, and guiding the tx. Talc should be prefered agent for pleurodesis. If the underlying lung can not expand then PPS should be considered.
Keywords: Malignant pleural effusion, pleurodesis, tube thoracostomy, talc, VATS
