Innovative Methods Treatment Of Metastatic Pleuritis.
Odessa National Medical University, Odessa, Ukraine.
OBJECTIVE: Innovative methods treatment of metastatic pleuritis. Odessa National Medical University Severgin V.E. Objective. A frequent complication of lung cancer is a metastatic carcinomatosis of the pleura. The main methods of treatment for these patients arethoracentesis, systemical chemotherapy, intrapleural chemotherapy, various types of pleurodesis. The effectiveness of intrapleural chemotherapy is estimated at 30-40% complete remission, ie, the absence of pleural effusion for more than 1 month. The use of different types of pleurodesis gives a positive effect in 68 - 89% of cases. Unsatisfactory results of treatment to encourage the search for the most effective techniques.
METHODS: Methods. We have proposed an innovative method for the treatment of metastatic pleuritis. The first step was performed thoracoscopic radiofrequency (RF) pleurodesis with the removal of large (up to 3 cm) metastases using RF generatorFotek 150 with monopolar electrodes. Power 60 W, time of 20-40 seconds per part of pleura. The second stage performed intrapleuralhyperthermicchemotherapy. For this purpose, the device Performer HT is used, mode 42-43oC, time 50 - 60 minutes, medicine: cytostatic cisplatin 50 mg per m2. This method is used by us in 11 patients with metastatic pleuritis. Time of observation of patients was 5 months.
RESULTS: Results. The observation period for patients was 5 months. During the research pleuritis relapse was observed in 1 (9%) patients at 3 months of treatment. There weren’t any serious complications during the postoperative period, only 2 patients had the inflammation in the projection of pleural drainage. This complication is associated with low immunity after conducted prior systemic chemotherapy.
CONCLUSIONS: Conclusion. The combination with RFpleurodesiswith the pleural hyperthermic chemotherapy not only improves the quality of life of patients, but also allows to extend it. This method requires further clinical studying.
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