Turkiye Klinikleri Cardiovascular Sciences

.: ORIGINAL RESEARCH
Analysis of Pleural Effusion Cases Diagnosed with Uniportal Video Assisted Thoracoscopic Surgery
Tek Port Video Yardımlı Torakoskopik Cerrahi Uygulanan Plevral Effüzyonlu Olguların Analizi
Miktat Arif HABERALa, Özlem ŞENGÖREN DİKİŞb, Erkan AKARa, Halil KAYAc
Departments of
aThoracic Surgery,
bPulmonary Diseases,
cEmergency Medicine,
University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital, Bursa, TURKEY
Turkiye Klinikleri J Cardiovasc Sci. 2019;31(1):36-40
doi: 10.5336/cardiosci.2018-63647
Article Language: EN
Full Text
ABSTRACT
 Objective: The aim of our study is to present and analysis of the pleural effusion (PE) cases diagnosed in the last 5 years by pleural puncture on pleurisy cases arriving at the emergency service, or persistent PE despite being followed up and treated at the pulmonary diseases clinic, or where the character of the fluid cannot be defined and finally treated with uniportal (single port) video assisted thoracoscopic surgery (VATS). Material and Methods: Between April 2012 and December 2017, it was found that a total of 407 patients with PE. Hospital records of 152 exudative PE (EPE) cases treated by VATS were retrospectively evaluated. The cases were subdivided into four groups on the basis of patient ages of 18-28; 29-39; 40-50 and 51 years and over, the diagnoses made for each group were noted along with the demographic characteristics, hospital stay after VATS and time taken for pleural drainage. Results: A total of 152 EPE cases with a mean age of 54.98 years(18-83 yr); consisting of 97 (63.8%) males were included in this study. The mean stay in our clinic was 7.2 (5-12) days; the mean time for tubed drainage took 4.6 (3-7) days. The causes of EPE were nonspecific pleurisy (NSP) (40.8%), malignancie (30.9%), tuberculosis (TB) (27.0%) and sarcoidosis (1.3%). Conclusion: In the aetiologies of EPE cases, with TB ranking first in underdeveloped countries and malignancies ranking first in the developed countries. In cases treated with uniportal VATS, incidences of TB, malignant pleurisy and malignant mesothelioma diagnoses are high and the procedure is reliable.

Keywords: Pleural effusion; uniport; VATS
ÖZET
 Amaç: Bu çalışmanın amacı, son 5 yılda acil servise başvuran ve plevral effüzyon (PE) tespit edilerek plevral ponksiyon yapılan, göğüs hastalıkları kliniğinde takip ve tedavi için izleme alınan ve sonrasında göğüs cerrahi kliniğinde tanı ve tedavi amaçlı uniportal (tek port) video destekli torakoskopik cerrahi (VATS) uygulanan olguların analiz edilmesidir. Gereç ve Yöntemler: Nisan 2012 ve Aralık 2017 arasında, PE'li toplam 407 hastadan, VATS ile tedavi edilen 152 eksudatif PE (EPE)'lu hastanın kayıtları retrospektif incelendi. Hastalar 18-28;29-39;40-50 ve 51 yaş ve üstü olmak üzere dört gruba ayrıldı. Her bir grubun demografik özellikleri, tanıları, VATS sonrası hastanede kalış süreleri ve plevral drenaj süreleri kaydedildi. Bulgular: Çalışmaya, yaş ortalaması 54,98 (18-83) yıl olan; 97 (%63,8)'si erkek olmak üzere toplam 152 EPE?lu hasta dahil edildi. Ortalama hastanede yatış süresi 7,2 (5-12) gün; ortalama plevral drenaj süresi 4,6 (3-7) gün idi. EPE'nin en sık nedenleri nonspesifik plörezi (NSP) (%40,8), maligniteler (%30,9), tüberküloz (TB) (%27,0) ve sarkoidoz (%1,3) olarak belirlendi. Sonuç: EPE etyolojisinde, gelişmekte olan ülkelerde ilk sırada TB ve gelişmiş ülkelerde malignite yer almaktadır. Uniportal VATS ile tanı konulan EPE'da TB, malign plörezi ve malign mezotelyoma tanı oranları yüksektir ve işlem güvenlidir.

Anahtar Kelimeler: Plevral effüzyon; uniport; VATS
REFERENCES:
  1. McGrath EE, Anderson PB. Diagnosis of pleural effusion: a systematic approach. Am J Crit Care. 2011;20(2):119-28. [Crossref ] [PubMed]
  2. Sahn SA. Pleural effusions of extravascular origin. Clin Chest Med. 2006;27(2):285-308. [Crossref] [PubMed]
  3. Sahn SA. The value of pleural fluid analysis. Am J Med Sci. 2008;335(1):7-15. [Crossref ] [PubMed]
  4. Diaz-Guzman E, Dweik RA. Diagnosis and management of pleural effusions: a practical approach. Compr Ther. 2007;33(4):237-46. [Crossref] [PubMed]
  5. Karkhanis VS, Joshi JM. Pleural effusion: diagnosis, treatment, and management. Open Access Emerg Med. 2012;4:31-52. [Crossref ] [PubMed] [PMC]
  6. Marel M. Epidemiology of pleural effusions. Eur Respir Mon. 2002;22:146-56.
  7. Light RW. Clinical practice. Pleural effusion. N Engl J Med. 2002;346(25):1971-7. [Crossref ] [PubMed]
  8. Light RW. Diagnostic approach in a patient with pleural effusion. Eur Respir Mon. 2002;22:131-45.
  9. Rocco G, Martin-Ucar A, Passera E. Uniportal VATS wedge pulmonary resections. Ann Thorac Surg. 2004;77(2):726-8. [Crossref]
  10. Rocco G, Brunelli A, Jutley R, Salati M, Scognamiglio F, La Manna C, et al. Uniportal VATS for mediastinal nodal diagnosis and staging. Interact Cardiovasc Thorac Surg. 2006;5(4):430-2. [Crossref ] [PubMed]
  11. Jutley RS, Khalil MW, Rocco G. Uniportal vs standard three-port VATS technique for spontaneous pneumothorax: comparison of post-operative pain and residual paraesthesia. Eur J Cardiothorac Surg. 2005;28(1):43-6. [Crossref ] [PubMed]
  12. Gonzalez-Rivas D, Fieira E, Delgado M, Mendez L, Fernandez R, de la Torre M. Is uniportal thoracoscopic surgery a feasible approach for advanced stages of non-small cell lung cancer? J Thorac Dis. 2014;6(6):641-8. [PubMed ] [PMC]
  13. Ng CS. Uniportal VATS in Asia. J Thorac Dis. 2013;5 Suppl 3:S221-5. [PubMed ] [PMC]
  14. Metintaş M. [Malignant Mesothelioma]. Göze G, Köktürk O, eds. Pleura Diseases. 1st ed. İstanbul: Turgut Yayıncılık; 2003. p.230-59.
  15. Senyiğit A, Babayiğit C, Gökirmak M, Topçu F, Asan E, Coşkunsel M, et al. Incidence of malignant pleural mesothelioma due to environmental asbestos exposure in the southeast of Turkey. Respiration. 2000;67(6):610-4. [Crossref ] [PubMed]
  16. Thomas SC, Davidson LR, McKean ME. An investigation of adequate volume for the diagnosis of malignancy in pleural fluids. Cytopathology. 2011;22(3):179-83. [Crossref ] [PubMed]
  17. Tozkoparan E, Deniz O, Cakir E, Yaman H, Ciftci F, Gumus S, et al. The diagnostic values of serum, pleural fluid and urine neopterin measurements in tuberculous pleurisy. Int J Tuberc Lung Dis. 2005;9(9):1040-5. [PubMed ]
  18. Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeager H Jr, Bresnitz EA, et al. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med. 2001;164(10 Pt 1):1885-9. [Crossref ] [PubMed]
  19. Rao DA, Dellaripa PF. Extrapulmonary manifestations of sarcoidosis. Rheum Dis Clin North Am. 2013;39(2):277-97. [Crossref ] [PubMed] [PMC]
  20. Huggins JT, Doelken P, Sahn SA, King L, Judson MA. Pleural effusions in a series of 181 outpatients with sarcoidosis. Chest. 2006;129(6):1599-604. [Crossref] [PubMed]
  21. Akter F, Routledge T, Toufektzian L, Attia R. In minor and major thoracic procedures is uniport superior to multiport video-assisted thoracoscopic surgery? Interact Cardiovasc Thorac Surg. 2015;20(4):550-5. [Crossref] [PubMed]
  22. Rocco G, Martucci N, La Manna C, Jones DR, De Luca G, La Rocca A, et al. Ten-year experience on 644 patients undergoing single-port (uniportal) videoassisted thoracoscopic surgery. Ann Thorac Surg. 2013;96(2):434-8. [Crossref ] [PubMed]

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