Abstract
Thoracoscopy is useful for the diagnosis of pleural diseases. The macroscopic features of carcinomatous pleurisy, tuberculous pleurisy, and malignant mesothelioma are specific. To determine the relationship between the success rate of pleurodesis and the macroscopic appearance of the pleural space revealed by thoracoscopy in patients with carcinomatous pleurisy. The subjects were 19 patients (12 men, 7 women with a mean age of 72.6 years), including 16 patients with lung cancer, 2 with gastric cancer, and 1 with colon cancer. We grouped the patients according to the following criteria ; A-1 suffered fsom multiple large tumors growing on the parietal or visceral pleura ; A-2, multiple large tumors growing on both surfaces of the pleura ; and B, multiple small nodules on both surfaces of the pleura. The criteria for measurement of efficacy were as follows : success was the disappearance or no change of pleural effusion at 4 weeks after pleurodesis and failure was an increase of the effusion. The success rate was 66.7% (4/6) for the A-1 cases and 71.4% (5/7) for the A-2 cases, but pleurodesis was only successful in 25% (1/4) of the B cases. When the relationship between the success rate of pleurodesis and the macroscopic appearance of carcinomatous pleurisy was examined, it was found that pleurodesis tended to fail when the patient had disseminated small nodules. Further investigation of a larger population is required to confirm these findings.
