RT Book, Section
A1 Sesti, Joanna
A1 Paul, Subroto
A1 Zellos, Lambros
A1 Bizekis, Costas S.
A1 Zervos, Michael D.
A1 Pass, Harvey I.
A2 Sugarbaker, David J.
A2 Bueno, Raphael
A2 Burt, Bryan M.
A2 Groth, Shawn S.
A2 Loor, Gabriel
A2 Wolf, Andrea S.
A2 Williams, Marcia
A2 Adams, Ann
SR Print(0)
ID 1170414204
T1 Management of Malignant Pleural Effusions
T2 Sugarbaker’s Adult Chest Surgery, 3e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260026931
LK accesssurgery.mhmedical.com/content.aspx?aid=1170414204
RD 2024/04/20
AB Malignant  pleural  effusions  (MPEs)  cause  considerable  morbidity  for  patients  afflicted  with  cancer.  Metastatic  breast,  lung,  and  ovarian  cancers  account  for  the  majority  of  cases.  Although  there  have  been  no  epidemiologic  studies,  the  annual  incidence  of  MPEs  in  the  United  States  is  estimated  to  be  more  than  200,000  cases.1,2  Initial  malignant  diagnosis  can  be  established  in  50%  to  60%  of  patients  by  means  of  a  therapeutic  thoracentesis.2,3  However,  the  malignant  effusions  often  recur,  and  patients  require  long-term  palliation.  The  ideal  therapy  permits  expedient,  low-cost  management  of  the  pleural  effusion  with  minimal  morbidity  because  many  of  these  patients  have  terminal  disease.  Nonoperative  management  of  MPEs  includes  systemic  chemotherapy  and  radiation  therapy,  as  well  as  several  methods  of  mechanical  drainage.  Operative  management  includes  drainage  through  the  use  of  video-assisted  thoracic  surgery  (VATS)  techniques  combined  with  pleurodesis,  as  well  as  operative  placement  of  indwelling  drainage  catheters  and  pleuroperitoneal  shunts.3–5