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

Alma Alihodzic-Pasalic, Veljko Maric, Ademir Hadzismailovic, Alen Pilav, Kemal Grbic

ABSTRACT

Background: Chemical pleurodesis is generally accepted palliative dyspnea therapy and preventiveof re-accumulation of pleural fluidin patients with malignant pleural effusions. Aim: Comparative analyses of efficiency of chemical pleurodesis between Video Assisted Thoracoscopic Surgery (VATS) and standard thoracostomy. Methods: From 01.01.2016-01.01.2017 at the Clinic for Thoracic Surgery of University Clinical Center (UCC) Sarajevo retrospective analysis was performed. Studied patients underwent VATS pleurodesis (G1) and standard thoracostomy pleurodesis (G2), with 60 in each group, respecting defined inclusion and exclusion criteria. Pleurodesissuccess was examined radiologically over the next three months. Results: Average age of all patients was 63.97±8.75 years. Gender related, 45% were men and 55% were women (F/M=1.47:1). Average hospitalisation was 7.22±1.37 (G1: 6.68±1.16; G2: 7.44±1.40; Mann-Whitney U-test: p=0.0016) days. Average thoracic drainage duration was 5.45±1.69, (G1: 4.28±1.15,G2: 6.05±1.58; Mann-Whitney U-test p<0.0001) days. Pleurodesis success after first month was 98.30% in G1, 91.60% in G2 (G1 vs. G2; p=0.2089); after second month was 98.30% in G1, 78.30% in G2 (G1 vs. G2; p=0.0011) and after three months was 91.60% in G1, 63.30% in G2(G1 vs. G2; p=0.0006). Average dyspnea degree (0-5) after the pleurodesis was 0.050±0.22 in G1 and 0.62±0.76 in G2 (Mann-Whitney U-test; p=0.0001). Complication were noticed in 9.2% patients, in G1 3.3%, 15.0% in G2. Conclusion: Difference in pleurodesis efficiency between the G1 and G2 was established after second month and was even more evident after third month in favour of G1. Results show the significant statistical improvement of the degree of dyspnea in G1 as opposite to the G2. Keywords: VATS pleurodesis, standard thoracostomy pleurodesis. FULL TEXT PDF

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