Pleurodèse chimique dans les épanchements pleuraux malins (EMP)
Y. Khelouia (Prof), S. Alihalassa*a (Prof)
a Public hospital establishment of Blida/faculty of medicine/university of Blida 1, Blida, ALGERIA
I-INTRODUCTION: chemical pleurodesis or talc Poudrage (TP) is one of the therapeutic options of MPE performed under medical thoracoscopy that has as objective, the pleural symphysis and the drying of the pleural effusion.
II-OBJECTIVE: To study the efficacy and safety of chemical pleurodesis.
III-MATERIALS AND METHODS: prospective study over three years including 46 patients with a proven or recurrent MPE with macroscopic features suggestive of neoplasia but systematically followed by biopsies. The TP carried out under TM, we used talc sterile, and the cyclines, we did not make the comparison between the two products. 82, 5% under local anesthesia (LA) and 17.5% LA + sedation. End examination by evaluation of diffusion of talc and pleural drainage.
52% women and 48% men were included, aged from 26 to 82 years with an average of 56.34 y. The neoplasic history found in 76%, 24 % have not neoplasic history. The breast cancer in 35%, lung in 15%, MPM in 7%,others in 20%.good diffusion is found in 87% against 13%, a pleural drainage is applied which lasted less than 5 days in 9%;5 days in 87% ; 5 to 10 days 2%;more than 11days 2%.
The post-operative complications are empyema 2%, air leaking 17.5%, fever 10.5%, subcutaneous emphysema 4%. No distress respiratory syndrome no death. Controlling at 30 days 85.5% pleurodesis success, at 60 days 80.5% of success.
VI- CONCLUSIONS: palliative treatment very effective and without risk for the patient against recurrence of effusion, dyspnea, and pain in MPE.
Keywords : pleurodesis, malignant pleural effusion ,efficiency
Disclosure of funding source(s): none