The Recent Effect Of Spraying Erythrocin Or Talc Powder In Video-assisted Thoracic Surgery To Treat The Non-small Cell Lung Cancer Patients With Malignant Pleural Effusion

Purpose:To study the recent effect of spraying erythrocin or talc powder in video-assisted thoracic surgery (VATS) to treat the non-small cell lung cancer (NSCLC) patients with malignant pleural effusion (MPE), and to improve therapy effect of pleurodesis, reducing complications, providing the basis of choosing and using hardening agent reasonably.Methods:Diagnosed NSCLC patients with MPE in VATS were randomly divided into two groups, each group had 22 cases. Therapeutic Group was treated with spraying erythrocin (Group A) and Control Group was treated with spraying talc power (Group B) in VATS. There were no differences in statistics of sex, age, tumor pathological type, tumor site, KPS(Karnofsky Performance Status),volume of pleural effusion and clinical symptoms between these two groups (P>0.05). Cellulose membranes of lung surface were cleared away, adhesions were separated, pleural nodules and peripheral pulmonary lung cancer were diagnosed by pathologists in operation. All the pleural nodules were cut or scorched as clearly as possible and the lung could expand as good as possible after surgery. Erythrocin (1.0g) or talc power (5.0g) was sprayed on the surface of lung equably. After operation, the patients were observed by blood routine, function of liver and kidney, X-ray and B ultrasonic of thoracic cavity, and all the patients were follow-up visited for 4 weeks. Volume and duration of pleural effusion were observed, when volume of pleural effusion was less than 100ml/d, the thoracic duct was pulled out.8 days after operation, all the patients accepted chemotherapy (Vinorelbine and cis-platinum). The treatment of MPE was valuated by WHO criterion. Side effect was observed during 7 days after surgery, in case that it was confused with the side effect of chemotherapy. Data was analyzed by PEMS 3.1 software; difference between groups was checked with X2 test and t test.Results:1. KPS average grades of both groups≥70,there was no significant difference. (P>0.05)2. The mean time of pulling out thoracic duct of group A was 80.18h, for group B was 78.68h, there was no significant difference.(P>0.05).3. The average volume of pleural effusion:Group A was 672.27ml, Group B was 633.64 ml. there was no significant difference. (P>0.05).4. Therapy effect:group A:effective rate 86.36%, group B:effective rate 90.91%. There was no significant difference of effective rate between two groups. (P>0.05). Rate of complete remission:group A:63.64%,group B:86.36%, there was no significant difference of effective rate between two groups.(P>0.05).5. Side effect:different degree of chest pain and fever were observed in all the cases of two groups, parts of patients thoracic pain rising of WBC, dizzy headache, nausea and vomiting, hyperglycemia abnormal liver function. There was no significant difference of side effect between two groups. (P>0.05).Conclusion:1. Both erythrocin and talc powder could be used in VATS to control malignant pleural effusion of non-small cell lung cancer patients.2. There were no significant difference of effective rate and side effect rate between two groups, and no severe side effect was obverted. The advantages of Pleurodesis by VATS are minimally invasive procedure, less complication, fast recovering, high rate of definite diagnosis and good expanding of lung after surgery.3. Erythrocin can be used as a substitute of talc powder to cure malignant pleural effusion, and has a significance of clinical spreading.