Jornal de Ensaios Clínicos
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Tratamento do derrame pleural pela combinação de pó de talco e cateter pleural de demora: um estudo retrospectivo de centro único

Gorensek BG, Schmid RA e Hoksch B

Objective: In 2013 we started to combine VATS poudrage with simultaneous insertion of an indwelling pleural catheter (IPC) for management of malignant pleural effusions (MPE) to achieve successful pleurodesis, avoid recurrence of MPE and shorten hospitalization time. The aim of this study was to distinguish whether the combination treatment is superior over standard VATS poudrage. Methods: This retrospective descriptive study analyses data of patients with MPE treated at our department since the implementation of the method. The historic control group included patients with MPE treated with VATS poudrage alone. Results: There were 117 patients, 67 patients were treated with the new approach (IPC group) and 50 patients with VATS talc poudrage (control group). Both groups were comparable in demographic data. The postoperative hospitalization time was significantly shorter in the IPC group (P=0.0001). Patients in the control group got 2 chest drains inserted (Ch 24/Ch 28) and in the IPC group 1 chest drain (Ch 24) plus the IPC. Chest drains could be removed quicker in the IPC group (P=<0.0001). So far there was not a single case of unsuccessful pleurodesis with our approach compared to 10% failure rate in the control group. Conclusion: The combined approach is a safe and effective approach in MPE prophylaxis. Patients were discharged earlier and further treatment, e.g., chemotherapy, could be initiated in time.