Comparing the results of VATS pleurectomy and talc pleurodesis with small sized catheter in randomised patients with malign pleural effusion

Objectives: Pleural effusion occurs as a result of detoriation in equilibrium between absorption and secretion. We aimed to investigate the clinical responses of talk pleurodesis and pleurectomy with video assisted thoracoscopic surgery (VATS) in patients with malignant pleural effusion. Materials and methods: Forty-five patients with malignant pleural effusion between June 2007 and June 2008 were included in this study. Thoracentesis was performed in order to study the biochemical, microbiologic, cytological analysis. Glucose, total protein, albumin, lactic dehydrogenases and cytological examination were studied in effusion and blood sample simultaneously. Cases were classified into two groups; in group I (n=25), small calibrated catheter and talk pleurodesis were performed. In group II (n=20), VATS pleurectomy was performed. Results: There were 32 females and 13 males with mean age 51.58 (27-75) years. Diagnosis was made with cytologic examination of pleural fluid that was aspirated with thoracentesis. Transudate- exudate discrimination was done according to Light’s criteria. Success rates of the groups were as complete response; 84% (n=21) in group I, 85% (n=17) in group II. Unsuccessful response was 16% (n=4) in group I and 15% (n=3) in group II. There was no statistically significant difference between hospital stay and tube duration of groups when compared to each other. Conclusion: The treatment of malignant pleural effusion is palliative due to poor prognosis. The purpose is to eliminate dyspnea in patients with short survival time. There was no significant difference between the VATS pleurectomy and talc pleurodesis that has been known as effective sclerosant agent.