EGO. Amédé, DIGONNET. Antoine, KHALIFE. Maher , HONTOIR. Sonia, SOSNOWSKI. Maurice
MOHAMMED BEN AZIZ , Thoracoscopic Talc Pleurodesis in Malignant Pleural Effusions: impact of high frequency jet ventilation on outcome(2016)SDRP Journal Of Anesthesia & Surgery 1(2)
Malignant pleural effusion is a complication of several types of advanced malignancy, which may significantly reduce the quality of life of patients.
Thoracoscopic talc pleurodesis is a feasible and effective treatment, but not devoid of complications such as respiratory complications. Airways management may play a role in the occurrence of these complications.
The purpose of the study is to evaluate the efficacy and safety of high frequency jet ventilation in the management of Thoracoscopic Talc Pleurodesis in Malignant Pleural Effusions.
We performed a retrospective study on patients, who underwent Thoracoscopic Talc Pleurodesis in Malignant Pleural Effusions, with the objectives to substantiate the complications and possible influence of high frequency jet ventilation, on the occurrence of respiratory complications.
137 files were reviewed over a period of 11 years. Medical history, anaesthetic charts, intravenous fluid use, anaesthesia method and analgesia, records of complications and length of hospital stay were analysed. Patients were divided into 2 groups according to the intraoperative airways management for thoracoscopy: One Lung Ventilation (n = 112) or double lung high frequency jet ventilation (n=25).
The average age was significantly higher in the jet ventilation group (p =0.03)
Intraoperative high frequency jet ventilation was significantly associated with less frequent blood loss (p=0.049). Respiratory complications such as pneumonia was found more often when intraoperative One Lung Ventilation was used (p = 0.023). No differences in the length of hospital stay but surgery time were significantly reduced (p<0.05).
The use of intraoperative pulmonary high frequency jet ventilation in Thoracoscopic Talc Pleurodesis in Malignant Pleural Effusions may reduce blood loss, durations of surgery and postoperative respiratory complications. These findings should be confirmed in large prospectives study.
Pleurodesis , Pleural effusion, thoracoscopy, , blood loss, pneumonia