The Recent Effect Of Video-assisted Thoracic Surgery To Treat The Malignant Pleural Effusion Patients With Malignant Pleural Effusion

Objective: To evaluate the video-assisted thoracoscopic pleurodesisclinical efficacy for the treatment of malignant pleural effusion.Methods: A retrospective analysis of patients with malignant pleuraleffusions in Jilin University Second Affiliated Hospital of Thoracic Surgerytreatment in January2008to January2012, then screened84cases, including48cases of male and female36cases; the age of32years old-82yearsoldaverage age of58.2years old。All patients were confirmed malignant pleuraleffusions before admission, no radiotherapy, chemotherapy and othersymptomatic treatment of cytology or tissue. In accordance with the differenttreatment methods, divided into two groups: closed thoracic drainage group:28males,14females; age36-82years, median age58.2years; thoracoscopicpleurodesis group:20males and22females cases; age32-78years old, with amedian age of56.7years. Efficient treatment of the two groups, Karnofskyscore in the two groups before and after surgery, the incidence of adversereactions, the average total drainage volume and the average drainage tube days,the number of indicators, all data SPSS13.0software for statistical analysis,using the χ2test between the two groups were compared using t-test, p <0.05difference was statistically significant. Video-assisted thoracoscopic pleuro-desis clinical value in the treatment of malignant pleural effusions.Results: The preoperative two groups of patients with gender, age andKamofsky score was no significant difference (P>0.05), two groups of patientsduring the hospital no one death. The the CR16cases of postoperative pleuralfluid drainage group, PR13cases, RR29cases, the treatment efficiency of69.05%. Karnofsky score before treatment,60.24±5.03, after treatment64.32with disabilities7.48.25cases of high fever (>38.5°C)8cases of severe chest pain (in need of analgesics as an indicator)17cases of adverse reactions (fever+severe chest pain), poor incidence of59.52%. The average total drainagevolume1941.23±324.9ml, the average chest tube drainage days, the numberof8.4±0.83days. No serious complications such as pneumothorax, ARDSoccurs. CR28cases of thoracoscopic pleurodesis group, PR11cases, the RR39cases, the treatment efficiency of92.86%. Karnofsky score before treatment,61.00±5.27, after treatment75.00with disabilities5.04. The occurrence ofhigh fever (>38.5°C)6cases of severe chest pain (required analgesics as anindicator)18cases of adverse reactions (fever+severe chest pain)(57.14%)improved after symptomatic treatment. The average total drainage volume of858.72±164.3ml, the average chest tube drainage days, and averaged4.2±0.37days. No serious complications such as pneumothorax, ARDS occurs. Twogroups of treatment efficiency and a significant difference (P <0.05),thoracoscopic pleural fixation group more effective than closed thoracicdrainage group. After treatment, Karnofsky score, P <0.05, significantdifference thoracoscopic pleurodesis for the Karnofsky score improvedsignificantly better than the closed thoracic drainage. Two sets of adversereactions (fever, chest pain) incidence, P>0.05, no significant difference. Thetwo groups in the average total drainage volume and the average drainage tubedays, P <0.05, thoracoscopic pleurodesis group were significantly less than theaverage total drainage volume and the average drainage tube days closedthoracic drainage group.Conclusion: Video-assisted thoracoscopic pleurodesis treatment ofmalignant pleural effusion treatment of chest tube drainage of local admini-stration is more effective.Video-assisted thoracoscopic pleurodesis can be used for both diagnosis,with less trauma, less pain, quicker recovery, and recurrence rate is low and theadvantages of clinical incomparable advantages of other diagnostic and treatment methods.With the continuous development of video-assisted thoracoscopic video-assisted thoracoscopic pleurodesis will become one of the clinical diagnosisand treatment of malignant pleural effusion is the most effective and mostcommonly used methods worthy of further promotion and application.