Effective treatment of malignant pleural effusion: thoracoscopic talcum pleurodesis and pleuroperitoneal shunt

Basic problem: Definitive palliation of malignant pleural effusion demands a therapeutic procedure that is efficient with a low risk of complication a nd death. This study was undertaken to evaluate the outcome of thoracoscopi c talcum pleurodesis (TTP), with insertion of pleuroperitoneal shunt (PPS) for permanent drainage, if indicated. Patients and methods: The results of treating malignant pleural effusions w ere analysed retrospectively in 36 patients (15 men, 21 women; mean age 65 [48 - 89] years) who had undergone 37 video-assisted TTP and 6 PPS. Results: TTP achieved significant improvement of dyspnoea in 89% of patient s a nd PPS succeeded in providing permanent internal drainage even in cases of adherent pleura. Conclusion: Video-assisted TTP is the method of choice in the palliative tr eatment of malignant pleural effusions in the still expanding lung. In case of an adherent nonexpanding lung PPS provides effective and permanent pall iation.