Comparison of Efficiency of Pleurodesis Between Video Assisted Thoracoscopic Surgery (VATS) and Standard Thoracostomy

Alihodžić-Pašalić, Alma; Maric, Veljko; Hadžismailović, Ademir; Pilav, Alen; Grbic, Kemal

doi:10.5455/aim.2018.26.185-189

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…The sample size was calculated using RCT for binary data formula. Estimated pleurodesis efficacy of talc and ABP were 98% 37 and 83%, 30 respectively. A power of 80% was set to determine the efficacy, with the alpha level at 0.05.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety profile of autologous blood versus talc pleurodesis for malignant pleural effusion: a randomized controlled trial

Keeratichananont

Kaewdech

Keeratichananont

2018

Ther Adv Respir Dis

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Background:Autologous blood is a novel, high-efficacy sclerosant for treatment of malignant pleural effusion (MPE), similar to tetracycline. There has been no comparative data between autologous blood and a worldwide sclerosant like talc. We aimed to compare the effectiveness of autologous blood versus talc pleurodesis.Methods:A prospective study was conducted at Songklanagarind Hospital, Songkhla, Thailand. A total of 123 symptomatic MPE cases were randomized to receive autologous blood pleurodesis (ABP) versus pleurodesis with talc slurry. In the ABP group, 100 ml of autologous venous blood was instilled through a chest drain, followed by 50 ml of sterile normal saline (NSS). In the talc group, 20 ml of 1% lidocaine diluted in 30 ml NSS was instilled, followed by 4 g of sterile talc (Steritalc®, a non-small particle size talc) suspended in 100 ml of NSS. A 30-day pleurodesis efficacy (according to Paladine’s criteria), along with the adverse events, was evaluated.Results:Fifty-six cases in the ABP, and 54 cases in the talc group completed the study. There was no difference between the two groups in the demographic data. The overall pleurodesis success rate at 30 days was 82.0% in the ABP group, comparable to the talc pleurodesis group (87.0%, p = 0.12). The percentage of fever (9.0% versus 28.0%, p = 0.04), amount of acetaminophen required by each participant (2.2 ± 0.7 versus 4.6 ± 0.9 tablets, p = 0.03), pain score and percentage of cases who needed opioids (9.0% versus 26.0%, p = 0.02) and hospital stay (10.2 ± 2.7 versus 12.8 ± 3.4, p = 0.04) were significantly lower in the ABP group; no infectious or serious events occurred.Conclusions:ABP had an equivalent efficacy compared to talc pleurodesis for MPE treatment. ABP offered less fever and pain and could shorten hospital stays, and neither produced means ABP did not produce clotted drainage, pulmonary or systemic adverse events.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety profile of autologous blood versus talc pleurodesis for malignant pleural effusion: a randomized controlled trial

Keeratichananont

Kaewdech

Keeratichananont

2018

Ther Adv Respir Dis

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“…Also, the recurrence rate varies wildly, depending on the identification and subsequent ablation of blebs, according to Naunheim et al The use of VATS or conventional thoracoscopy and pleurodesis, or thoracotomy, is dependent upon several factors, and there is no precise technique of choice. VATS would be recommendable in young patients with recurrent pneumothorax, combined with some technique to induce pleural symphysis (usually mechanical pleural abrasion or apical talc pleurodesis) [24,27].…”

Section: Video-assisted Thoracoscopic Surgery (Vats): Pleurodesismentioning

confidence: 99%

Understanding The Acute Interventions for Complicated Pleural Effusions

Gomez-Coral

2023

IJOPRS

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Pleural effusion affects approximately 1.5 million individuals in the U.S. annually. A significant subset of these cases evolves into complicated parapneumonic effusions due to bacterial infections, intense inflammation, or other causal factors, presenting considerable diagnostic and therapeutic challenges. If untreated, the condition's sequential progression can culminate in restrictive respiratory dysfunction. This review examines the diverse interventions available for diagnosing and treating complicated pleural effusions. The therapeutic spectrum ranges from minimally invasive procedures such as thoracentesis and Intrapleural Enzymatic/Fibrinolytic Therapy (IPET) to surgical interventions, including Video-assisted Thoracoscopic Surgery (VATS) for pleurodesis and pleurectomy/decortication, and open pleurectomy/decortication. Notably, the combined use of agents in IPET presents a significant advancement, especially for patients unsuitable for surgery. Furthermore, VATS emerges as a promising, less invasive surgical alternative, and the role of pleurectomy/decortication in managing malignant mesothelioma becomes more pronounced, offering advantages over other surgical modalities. The diagnostic and therapeutic landscape for complicated pleural effusions is vast and continues to evolve, with an increasing emphasis on minimizing invasiveness and optimizing patient outcomes. As clinical approaches diversify and improve, ensuring patient-centric care becomes paramount. The future of this domain rests on refining current practices and further investigating newer interventions to elevate patient outcomes.

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Pleurodesis: From Thoracic Surgery to Interventional Pulmonology

Tabba

Yasufuku

2021

Respiratory Medicine

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Comparison of Efficiency of Pleurodesis Between Video Assisted Thoracoscopic Surgery (VATS) and Standard Thoracostomy

Cited by 3 publications

References 20 publications

Efficacy and safety profile of autologous blood versus talc pleurodesis for malignant pleural effusion: a randomized controlled trial

Efficacy and safety profile of autologous blood versus talc pleurodesis for malignant pleural effusion: a randomized controlled trial

Understanding The Acute Interventions for Complicated Pleural Effusions

Pleurodesis: From Thoracic Surgery to Interventional Pulmonology

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