PLEURECTOMY FOR MESOTHELIOMA

被引:38
作者
BRANCATISANO, RP
JOSEPH, MG
MCCAUGHAN, BC
机构
[1] ROYAL PRINCE ALFRED HOSP,CARDIOTHORAC SURG UNIT,MISSENDEN RD,CAMPERDOWN,NSW 2050,AUSTRALIA
[2] REPATRIAT GEN HOSP,DEPT SURG,CONCORD,NSW 2139,AUSTRALIA
关键词
D O I
10.5694/j.1326-5377.1991.tb121175.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To assess the effectiveness and safety of parietal pleurectomy in establishing a tissue diagnosis and controlling pleural fluid accumulation in patients with pleural mesothelioma, and to assess the success of this procedure in effecting palliation. Design and setting: Fifty consecutive patients with pleural mesothelioma who underwent thoracotomy at the cardiothoracic units at Concord and Royal Prince Alfred Hospital were reviewed retrospectively. The male:female ratio was 4:1 and the mean age was 63 years. In only 11 of the 50 patients was a tissue diagnosis of mesothelioma made before surgery. Interventions: At thoracotomy, subtotal parietal pleurectomy was performed in 45 of the 50 patients. In two patients biopsy alone was performed and three patients were treated by a chemical pleurodesis only, as pleurectomy was not technically possible. Pulmonary decortication was required in 28 patients to allow full expansion of the underlying lung for effective pleurodesis. Results: There was one postoperative death. The morbidity rate was 16%. Excluding the patient who died in the postoperative period, the median survival was 16 months, and ranged from three to 54 months, with 21% of patients surviving for more than two years. Only one patient developed a reaccumulation of pleural fluid. Conclusions: Pleurectomy, with decortication when required, provides both a tissue diagnosis and effective control of pleural fluid accumulation and therefore excellent palliation in patients with pleural mesothelioma. We advocate early thoracotomy in these patients.
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页码:455 / &
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