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https://www.readbyqxmd.com/read/29325199/-efficacy-and-safety-of-indwelling-pleural-catheters
#1
Eva Lücke, Uwe Steffen, Sandra Riedel, Jens Schreiber
In symptomatic malignant pleural effusions, mostly in a palliative situation, therapeutic procedures should be chosen to improve dyspnoea and the concomitant impairment of quality of life. Indwelling pleural catheters (IPC) have played an increasing role in recent years. The efficacy and safety of this method have not been adequately clarified under real-life clinical conditions. 94 patients, in whom IPC had been implanted because of a clinical indication, were analysed retrospectively with respect to efficacy and safety, together with patient characteristics, peri- and postinterventional complications, e...
January 11, 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29320805/success-rate-of-medical-thoracoscopy-and-talc-pleurodesis-in-malignant-pleurisy-a-single-centre-experience
#2
Joke Leemans, Christophe Dooms, Vincent Ninane, Jonas Yserbyt
BACKGROUND AND OBJECTIVE: Malignant pleurisy is associated with advanced oncological disease and dyspnoea is the most common presenting symptom. Pleurodesis is the preferred palliative and supportive treatment option, targeting symptom relief. The identification of clinical and endoscopic features that determine the success of talc pleurodesis in malignant pleurisy could guide clinical decision-making. METHODS: All symptomatic patients with malignant pleurisy subjected to talc pleurodesis through medical thoracoscopy between January 2012 and December 2015 were included...
January 10, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29312767/minor-regression-and-long-time-survival-56-months-in-a-patient-with-malignant-pleural-mesothelioma-under-viscum-album-and-helleborus-niger-extracts-a-case-report
#3
Paul G Werthmann, Gerhard Saltzwedel, Gunver S Kienle
Malignant pleural mesothelioma (MPM) is a rare cancer with a dismal prognosis. Viscum album extracts (VAE) have strong immune stimulatory properties, cytotoxic effects, can downregulate cancer genes and inhibit angiogenesis. VAE are often used as an adjunct treatment in cancer patients but have rarely been investigated in MPM. Helleborus niger extracts (HNE) have been used in anticancer therapy since antiquity, and also show tumor specific cytotoxic effects. We present a case of a 64-year old woman with epithelioid MPM of the right chest with node involvement (T2N1M0, stage III)...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29312753/review-of-malignant-pleural-mesothelioma-survival-after-talc-pleurodesis-or-surgery
#4
REVIEW
Emanuela Taioli, Maaike van Gerwen, Meredith Mihalopoulos, Gil Moskowitz, Bian Liu, Raja Flores
Malignant pleural mesothelioma (MPM) is an aggressive tumor and the prognosis is still dismal despite the various proposed multimodal treatment plans. Currently, new palliative treatments, such as talc pleurodesis, are being explored besides traditional surgery. This review reports survival rates after talc pleurodesis in comparison to surgery in patients with malignant pleural mesothelioma. A systematic literature search yielded 49 articles eligible for this review. The mean survival in the talc pleurodesis group was 14 months compared to 17 and 24 months for the pleurectomy decortication (P/D) group and extrapleural pneumonectomy (EPP) group, respectively...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29277182/-application-of-digital-drainage-system-in-postoperative-refractory-prolonged-air-leaks-after-pulmonary-surgery
#5
Donglai Chen, Xiermaimaiti Kadeer, Zhe Shi, Yuxing Jin, Chang Chen
BACKGROUND: Postoperative prolonged air leaks is one of the most common complications secondary to pulmonary resections. Digital drainage system (DDS) is considered as an accurate and objective device which has been found to be comfortable and well tolerated by patients, economical as well. The aim of this study is to explore the application of DDS in patients with postoperative refractory prolonged air leaks after pulmonary surgery. METHODS: Prolonged air leak (PAL) is defined as air leaks lasting for more than 5 d after video-assisted surgery or more than 7 d after thoracotomy...
December 20, 2017: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/29273336/self-appraised-readiness-of-senior-and-graduating-general-surgery-residents-to-perform-thoracic-surgery
#6
Zachary M DeBoard, Michael Paisley, Donald D Thomas
OBJECTIVE: General surgeons perform up to 50% of noncardiac thoracic surgery (TS). Although data show consistent TS case volume during general surgery (GS) residency it is unknown whether this operative trend will persist given potentially limited subspecialty exposure. We sought to determine if certain aspects of residency programs and resident characteristics were associated with trainees' perceived comfort in performing certain basic TS procedures. DESIGN: An anonymous survey was distributed to GS residents regarding program characteristics, presence of a TS residency, and intent to pursue thoracic surgical training, and estimated case volumes of individual procedures...
December 19, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29261577/description-of-particle-size-distribution-and-behavior-of-talc-preparations-commercially-available-within-the-united-states
#7
Christopher R Gilbert, Benjamin R Furman, David J Feller-Kopman, Philippe Haouzi
BACKGROUND: Widespread use of talc pleurodesis remains controversial for many providers concerned by adverse events such as respiratory failure, which are sometimes fatal. Particle talc size has been implicated in these adverse effects, mainly on the basis of animal studies utilizing large amounts of talc or in observational studies performed on different continents with different talc preparations and doses. Our aim was to determine the particle size and distribution of only the commercially available US-talc preparations and whether the fluid content can affect this distribution...
January 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29249857/symptomatic-fluid-drainage-tunneled-peritoneal-and-pleural-catheters
#8
REVIEW
Tony Ha, David C Madoff, David Li
Malignant ascites and pleural effusion are significant contributors to patient symptoms such as shortness of breath, abdominal distension, and nausea in the setting of cancer. There are numerous methods employed to control such symptoms such as serial drainages, pleurodesis, and tunneled drainage catheters. Tunneled drainage catheters are a safe, effective, and a minimally invasive procedure to palliate the symptoms of malignant ascites and pleural effusion.
December 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29225889/efficacy-of-sonographic-and-biological-pleurodesis-indicators-of-malignant-pleural-effusion-simple-protocol-of-a-randomised-controlled-trial
#9
Ioannis Psallidas, Hania E G Piotrowska, Ahmed Yousuf, Nikolaos I Kanellakis, Gayathri Kagithala, Seid Mohammed, Lei Clifton, John P Corcoran, Nicky Russell, Melissa Dobson, Robert F Miller, Najib M Rahman
Introduction: Malignant pleural effusion (MPE) is common and currently in UK there are an estimated 50 000 new cases of MPE per year. Talc pleurodesis remains one of the most popular methods for fluid control. The value of thoracic ultrasound (TUS) imaging, before and after pleurodesis, in improving the quality and efficacy of care for patients with MPE remains unknown. Additionally, biomarkers of successful pleurodesis including measurement of pleural fluid proteins have not been validated in prospective studies...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29221335/chylothorax-after-mediastinal-ganglioneuroma-resection-treated-with-fibrin-sealant-patch-a-case-report
#10
Marco Chiarelli, Pietro Achilli, Angelo Guttadauro, Giuseppe Vertemati, Sabina Terragni, Matilde De Simone, Ugo Cioffi
Chylothorax is a severe condition resulting from the accumulation of chyle into the pleural space. We report the treatment of postoperative chylothorax after resection of mediastinal ganglioneuroma in a 17-year-old boy. Since conservative measures were not effective, we performed direct ligation of lymphatic vessels and pleurodesis. At subsequent surgical re-exploration for persisting chylothorax, accurate inspection of pleural cavity revealed residual chyle leakage. Fibrin sealant patches (TachoSil®) were placed over the source of leak with complete resolution of chylous effusion...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29221288/pleurodesis-a-comparison-of-two-sclerosing-agents-for-pleural-effusions-in-mozambique
#11
Ivo Figueiredo, Anilsa Cossa, Anila Hassane, José Sousa, Joaquim Pondo, João Teixeira, Kevan Akrami, Susannah K Graves, Atul Malhotra, Elizabete A Nunes
Background: Pleural effusions constitute one of the most frequent pathologies encountered in the pulmonary service of Maputo Central Hospital (MCH) in Mozambique. Bleomycin and talc are commonly used for pleurodesis, but cost prohibitive, therefore we aimed to retrospectively compare the efficacy and safety of sodium hydroxide (NaOH) with bleomycin for pleurodesis. Methods: Case records of pleurodesis using bleomycin and NaOH from 2002 to 2013 were reviewed. Standard of care for pleurodesis for recurrent pleural effusions at MCH was developed using the materials available...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29214061/medical-thoracoscopy-and-its-evolving-role-in-the-diagnosis-and-treatment-of-pleural-disease
#12
REVIEW
Vivek Murthy, Jamie L Bessich
Establishing the etiology of exudative pleural effusions in the setting of an unrevealing pleural fluid analysis often requires biopsies from the parietal pleura. While closed pleural biopsy (CPB) has been a popular minimally-invasive approach, it has a poor diagnostic yield, barring a diagnosis of tuberculous pleurisy. Medical thoracoscopy (MT) is a minimally-invasive ambulatory procedure performed under local anesthesia or moderate sedation which allows for direct visualization of biopsy targets as well as simultaneous therapeutic interventions, including chemical pleurodesis and indwelling tunneled pleural catheter (ITPC) placement...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29199894/local-and-systemic-effects-of-a-silver-nitrate-coated-indwelling-pleural-catheter-in-an-animal-model-of-pleurodesis
#13
Alain Tremblay, Christine T Kearney, Chris Hanks, Jennifer Hughes Hanks, David S White, Marcia E Pereira, Craig E Zook, Karen Sargis, Luke Zhang
Purpose/Aim of the study: This study assessed the safety and potential toxicity of a silver nitrate coated indwelling pleural catheter (SNCIPC) designed to create pleurodesis in a large animal model. MATERIALS AND METHODS: Sixteen animals underwent insertion of either a SNCIPC or an uncoated silicone catheter. Half of the animals were sacrificed at day 7 and the others at day 30. Animal weight and assessment of well-being, pleural fluid and blood collection were performed at regular intervals...
November 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/29197468/characteristics-of-patients-with-myelomatous-pleural-effusion-a-systematic-review
#14
V Riveiro, L Ferreiro, M E Toubes, A Lama, J M Álvarez-Dobaño, L Valdés
BACKGROUND: Myelomatous pleural effusion (MPE) is rare in multiple myeloma, and therefore its characteristics are not well defined. METHODS: A systematic review (4 online databases) was conducted of articles describing the clinical characteristics of patients with MPE, pleural effusion's biochemical characteristics and treatment efficacy. We analysed isolated cases and small retrospective series. RESULTS: We included 98 articles with a total of 153 patients with MPE...
November 29, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/29164255/effect-of-an-indwelling-pleural-catheter-vs-talc-pleurodesis-on-hospitalization-days-in-patients-with-malignant-pleural-effusion-the-ample-randomized-clinical-trial
#15
RANDOMIZED CONTROLLED TRIAL
Rajesh Thomas, Edward T H Fysh, Nicola A Smith, Pyng Lee, Benjamin C H Kwan, Elaine Yap, Fiona C Horwood, Francesco Piccolo, David C L Lam, Luke A Garske, Ranjan Shrestha, Christopher Kosky, Catherine A Read, Kevin Murray, Y C Gary Lee
Importance: Indwelling pleural catheter and talc pleurodesis are established treatments for malignant pleural effusions among patients with poor prognosis. Objective: To determine whether indwelling pleural catheters are more effective than talc pleurodesis in reducing total hospitalization days in the remaining lifespan of patients with malignant pleural effusion. Design, Setting, and Participants: This open-label, randomized clinical trial included participants recruited from 9 centers in Australia, New Zealand, Singapore, and Hong Kong between July 2012 and October 2014; they were followed up for 12 months (study end date: October 16, 2015)...
November 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29155978/results-of-repeated-video-assisted-thoracic-surgery-for-recurrent-pneumothorax-after-primary-spontaneous-pneumothorax
#16
Sukki Cho, Sanghoon Jheon, Dong Kwan Kim, Hyeong Ryul Kim, Dong Myung Huh, Sungsoo Lee, Kyoung Min Ryu, Deog Gon Cho
OBJECTIVES: This study aimed to identify the causes of recurrent pneumothorax and to evaluate the results of repeated video-assisted thoracic surgery (VATS) for recurrent pneumothorax after VATS wedge resection for primary spontaneous pneumothorax (PSP). METHODS: A retrospective review was conducted on 188 patients with recurrent PSP, of a population of 1414 patients who underwent VATS wedge resection for PSP. Reoperations were performed when an air leak persisted longer than 3 days after closed thoracostomy, when a visible bulla of greater than 1 cm on high-resolution computed tomography (HRCT) was observed and when rerecurrence took place after other treatments...
November 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29140122/lymphangioleiomyomatosis-diagnosis-and-management-high-resolution-chest-computed-tomography-transbronchial-lung-biopsy-and-pleural-disease-management-an-official-american-thoracic-society-japanese-respiratory-society-clinical-practice-guideline
#17
Nishant Gupta, Geraldine A Finlay, Robert M Kotloff, Charlie Strange, Kevin C Wilson, Lisa R Young, Angelo M Taveira-DaSilva, Simon R Johnson, Vincent Cottin, Steven A Sahn, Jay H Ryu, Kuniaki Seyama, Yoshikazu Inoue, Gregory P Downey, MeiLan K Han, Thomas V Colby, Kathryn A Wikenheiser-Brokamp, Cristopher A Meyer, Karen Smith, Joel Moss, Francis X McCormack
BACKGROUND: Recommendations regarding key aspects related to the diagnosis and pharmacological treatment of lymphangioleiomyomatosis (LAM) were recently published. We now provide additional recommendations regarding four specific questions related to the diagnosis of LAM and management of pneumothoraces in patients with LAM. METHODS: Systematic reviews were performed and then discussed by a multidisciplinary panel. For each intervention, the panel considered its confidence in the estimated effects, the balance of desirable (i...
November 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29132697/treatment-of-postsurgical-chylothorax
#18
Janani S Reisenauer, Carlos A Puig, Chris J Reisenauer, Mark S Allen, Emily Bendel, Stephen D Cassivi, Francis C Nichols, Rob K Shen, Dennis A Wigle, Shanda H Blackmon
BACKGROUND: Postoperative chylothorax can be managed by any or all of observation, parenteral nutrition, surgical duct ligation, pleurodesis, or thoracic duct embolization. The objective of this study was to determine the efficacy of standard therapies, such as surgical duct ligation and observation, compared with newer treatment methods (thoracic duct embolization). METHODS: A prospectively maintained database at a single institution was used to identify and review patients with postoperative chylothorax from 2008 to 2015...
January 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29131094/pleurodesis-using-mistletoe-extract-delivered-via-a-spray-catheter-during-semirigid-pleuroscopy-for-managing-symptomatic-malignant-pleural-effusion
#19
Jung Seop Eom, Hyo Yeong Ahn, Jeong Ha Mok, Geewon Lee, Eun-Jung Jo, Mi-Hyun Kim, Kwangha Lee, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee
BACKGROUND: Talc poudrage during thoracoscopy is considered the standard procedure for patients with symptomatic malignant pleural effusion (MPE). Until now, no alternative technique other than talc poudrage for pleurodesis during medical thoracoscopy has been proposed. Liquid sclerosants, such as mistletoe extract, have been sprayed evenly into the pleural cavity during semirigid pleuroscopy for chemical pleurodesis. OBJECTIVE: We conducted a retrospective study using the database of semirigid pleuroscopy to identify the usefulness of pleurodesis using a mistletoe extract delivered via a spray catheter during semirigid pleuroscopy for symptomatic MPE...
November 7, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29123933/hemoptysis-following-talc-pleurodesis-in-a-pneumothorax-patient
#20
Yusuke Kakiuchi, Fumihiro Yamaguchi, Makoto Hayashi, Yusuke Shikama
The purpose of this article is to report a case of hemoptysis occurring in combination with secondary spontaneous pneumothorax following chemical pleurodesis by talc. A Japanese male with cancer of renal pelvis was found with the left pneumothorax and multiple lung metastases. A computed-tomography scan revealed severe emphysema throughout the lungs. Talc pleurodesis was employed to arrest air leakage. The patient developed hemoptysis 45 minutes after talc injection into the thorax. This is the first report of hemoptysis following talc pleurodesis...
2017: Case Reports in Pulmonology
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