139 results match your criteria failed pleurodesis

Hemorrhagic Malignant Pleural Effusion: Diagnosis, Survival Rate, and Response to Talc Pleurodesis.

Indian J Surg Oncol 2021 Mar 14;12(1):54-60. Epub 2020 Nov 14.

Department of Thoracic Surgery, western Galilee medical center, Nahariya, Israel.

Hemorrhagic malignant pleural effusion (HMPE) is diagnosed in 47-50% of all malignant pleural effusions (MPE). The aim of this study is to evaluate clinical, radiological, and morphological manifestations of HMPE and results of talc pleurodesis treatment. This is a retrospective review of the medical charts of 135 MPE patients which consists of HMPE group (42 patients) and simple MPE group (63 patients) (median age 67. Read More

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Thoracic duct injury after decortication of lung, new technique to repair thoracic duct in this challenging situation: A case report.

Asian Cardiovasc Thorac Ann 2021 Mar 2:218492321997080. Epub 2021 Mar 2.

Internal Medicine, Chettinad Hospital and Research Institute, Kanchipuram, India.

Background: Chylothorax is a rare form of pleural effusion that can be associated with both traumatic and non-traumatic causes. Very few patients respond to conservative line of therapy. Thoracic duct ligation is often the treatment of choice in post-surgical patients; however, the optimal treatment of this disease process after traumatic injury remains unclear. Read More

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Rapidly recurring massive pleural effusion as the initial presentation of sarcoidosis: A case report.

Medicine (Baltimore) 2021 Feb;100(6):e24027

Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar.

Rationale: Sarcoidosis is a multisystem granulomatous disease with unknown etiology. It affects mainly the lungs, but it can affect almost any other organ. Nevertheless, pleural involvement with the development of pleural effusion is relatively rare. Read More

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February 2021

A review of the outcomes of rigid medical thoracoscopy in a large UK district general hospital.

Pleura Peritoneum 2020 Nov 2;5(4):20200131. Epub 2020 Nov 2.

Northumbria HealthCare NHS Foundation Trust, Care of Tracy Groom, Cramlington, Northumberland, UK.

Objectives: Local anesthetic medical thoracoscopy (LAT) is a well-established diagnostic, therapeutic, and preventative intervention in undiagnosed pleural effusions with a high diagnostic sensitivity and low complication rates. There is a large variability in practice. We describe a nine-year experience in a large district general hospital in England. Read More

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November 2020

The Inflammatory Cytokine Profile of Patients with Malignant Pleural Effusion Treated with Pleurodesis.

J Clin Med 2020 Dec 11;9(12). Epub 2020 Dec 11.

Ph.D. Program in Medical Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan.

Patients with malignant pleural effusion (MPE) who underwent successful pleurodesis survive longer than those for whom it fails. We hypothesize that the therapy-induced inflammatory responses inhibit the cancer progression, and thereby lead to a longer survival. Thirty-three consecutive patients with MPE that were eligible for bleomycin pleurodesis between September 2015 and December 2017 were recruited prospectively. Read More

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December 2020

Pleural Space Elastance and Its Relation to Success Rates of Pleurodesis in Malignant Pleural Effusion.

Tuberc Respir Dis (Seoul) 2021 Jan 9;84(1):67-73. Epub 2020 Nov 9.

Department of Chest Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.

Background: Pleurodesis fails in 10%-40% of patients with recurrent malignant pleural effusions malignant pleural effusion and dyspnea. This study aimed to assess the values of pleural elastance (PEL) after the aspiration of 500 mL of pleural fluid and their relation to the pleurodesis outcome, and to compare the pleurodesis outcome with the chemical characteristics of pleural fluid.

Methods: A prospective study was conducted in Kasr El-Aini Hospital, Cairo University, during the period from March 2019 to January 2020. Read More

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January 2021

[A Case of Malignant Pleural Effusion Implanted Subcutaneous Pleural Port].

Gan To Kagaku Ryoho 2020 Oct;47(10):1489-1491

Dept. of Gastrointestinal Surgery, International University of Health and Welfare Shioya Hospital.

A 74-year-old man with malignant pleural effusion due to recurrent gastric cancer underwent a failed pleurodesis. He subsequently underwent subcutaneous implantable pleural port implantation surgery followed by outpatient chemotherapy for 1 month. His disease progressed and he was unable to go to the hospital. Read More

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October 2020

Refractory thoracic endometriosis.

BMJ Case Rep 2020 Aug 18;13(8). Epub 2020 Aug 18.

Department of Pulmonary/Critical Care, Geisinger Community Medical Center, Scranton, Pennsylvania, USA.

Thoracic endometriosis syndrome (TES) is a rare entity caused by thoracic implantation of endometrial tissue, manifesting as catamenial pneumothorax, pleural effusion and haemoptysis in young female individuals. Its management and long-term prevention of recurrences, can be challenging. We present the case of a young woman who presented with recurrent pneumothorax, haemopneumothorax and pleural effusion. Read More

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Indications and clinical outcomes of indwelling pleural catheter placement in patients with malignant pleural effusion in a cancer setting hospital.

Clin Respir J 2020 Nov 28;14(11):1040-1049. Epub 2020 Aug 28.

Fellow of College of Chest Physicians, Member Royal College of Physicians Ireland, Consultant Pulmonology, Shaukat Khanum Memorial Cancer Hospital & Research Center, Lahore, Pakistan.

Background: The placement of indwelling pleural catheters (IPC) is an effective outpatient approach for the management of malignant pleural effusions (MPE).

Aims: The indications and outcome of IPC in patients with MPE. Risk stratifications, prevention and management of IPC-related complications. Read More

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November 2020

Resolution of refractory chylothorax with a combination of talc pleurodesis and CPAP.

Respirol Case Rep 2020 Oct 15;8(7):e00624. Epub 2020 Jul 15.

Pulmonology Unit, Department of Medicine, Faculty of Medicine Universiti Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia.

Chylothorax is an uncommon cause of pleural effusion. Recurrent chylous effusions are often resistant to conservative treatment and many need surgical intervention. We report a 69-year-old woman with refractory idiopathic chylothorax resistant to medium-chain triglyceride diet and intermittent thoracentesis. Read More

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October 2020

Healthcare interventions improving and reducing quality of life in children at the end of life: a systematic review.

Pediatr Res 2020 Jul 9. Epub 2020 Jul 9.

End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels Health Campus-Building K Laarbeeklaan 103, 1090, Brussels, Belgium.

Background: Children with serious illness suffer from symptoms at the end of life that often fail to be relieved. An overview is required of healthcare interventions improving and decreasing quality of life (QOL) for children with serious illness at the end of life.

Methods: A systematic review was performed in five databases, January 2000 to July 2018 without language limit. Read More

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Birt-Hogg-Dubé syndrome presenting with macroscopic pulmonary cyst formation in a 15-year-old.

Respirol Case Rep 2020 Aug 24;8(6):e00610. Epub 2020 Jun 24.

Department of Thoracic Medicine St Vincent's Hospital Sydney NSW Australia.

Birt-Hogg-Dubé (BHD) syndrome is a rare, autosomal dominant disorder caused by a germline mutation in the folliculin gene (17p11.2). It is characterized by benign skin lesions, renal tumours, and pulmonary cysts, with pneumothoraces seen exceptionally rarely in patients younger than 40 years. Read More

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Exclusive ambulatory management of spontaneous pneumothorax with pigtail catheters, a prospective multicentric study.

Respir Med 2020 05 16;166:105931. Epub 2020 Mar 16.

Service de pneumologie, centre de compétences pour les maladies pulmonaires rares, Hôpital Pontchaillou, Rennes, France; IRSET UMR 1085, Université de Rennes 1, Rennes, France.

Objective: Spontaneous pneumothorax occurs most frequently in young active patients. Published guidelines do not all agree about its initial management; most patients are hospitalised and treated with chest tube. This prospective multicentric cohort study was designed to assess the potential of ambulatory management. Read More

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Thoracic endometriosis syndrome: Cutting the gordian knot - A case report and review of the literature.

Int J Surg Case Rep 2020 27;66:68-71. Epub 2019 Nov 27.

Cardiothoracic Surgery Unit, Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Introduction: Thoracic Endometriosis Syndrome (TES) is a rare disorder characterized by the presence of functional endometrial tissue in the thoracic cavity, often associated with the visceral or parietal pleura, lung parenchyma or airways. The aim of this case report is to illustrate the classic manner of presentation of TES and the modalities of therapy employed in a low-resource setting in the South-Western region of Nigeria.

Case Presentation: We report the case of a 37-year old woman who presented with right-sided pleuritic chest pain, cough and dyspnea closely associated with her menstrual cycle. Read More

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November 2019

[Hepatic hydrothorax: presentation of 3 cases with different therapeutic approaches].

Rev Gastroenterol Peru 2019 Jan-Mar;39(1):64-69

Universidad Libre. Barranquilla, Colombia.

Hepatic hydrothorax is uncommon transudative pleural effusion greater than 500 ml in association with cirrhosis and portal hypertension. Ascites is also present in most of the patients and the pathophysiology include the passage of ascites fluid through small diaphragmatic defects. After diagnostic thoracentesis studies, the first line management is restricting sodium intake and diuretics combination including stepwise dose of spironolactone plus furosemide. Read More

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January 2020

Clinical outcomes of chemical pleurodesis using a minocycline.

Ther Adv Respir Dis 2019 Jan-Dec;13:1753466619841231

PhD Program in Medical Biotechnology, College of Medical Science and Technology, Taipei Medical University; School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 110.

Background: Pleurodesis is often used to prevent the re-accumulation of a malignant pleural effusion (MPE). Intrapleural urokinase (IPUK) therapy facilitates lung re-expansion for patients with loculated MPE or a trapped lung that allows subsequent pleurodesis. MPE management has been traditionally regarded as a symptomatic treatment. Read More

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Management of Malignant Pleural Effusions. An Official ATS/STS/STR Clinical Practice Guideline.

Am J Respir Crit Care Med 2018 10;198(7):839-849

Background: This Guideline, a collaborative effort from the American Thoracic Society, Society of Thoracic Surgeons, and Society of Thoracic Radiology, aims to provide evidence-based recommendations to guide contemporary management of patients with a malignant pleural effusion (MPE).

Methods: A multidisciplinary panel developed seven questions using the PICO (Population, Intervention, Comparator, and Outcomes) format. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach and the Evidence to Decision framework was applied to each question. Read More

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October 2018

Intractable pneumothorax due to rupture of subpleural rheumatoid nodules: a case report.

Surg Case Rep 2018 Aug 8;4(1):89. Epub 2018 Aug 8.

Department of General Thoracic Surgery, Ayabe City Hospital, 20-1 Otsuka, Aono-cho, Ayabe, Kyoto, 623-0011, Japan.

Background: In rare cases, rheumatoid pleural nodules can rupture into the pleural cavity to cause pneumothorax or empyema. We report successful surgical treatment of a patient with an intractable secondary pneumothorax due to rupture of a subpleural rheumatoid nodule into the pleural cavity.

Case Presentation: A 75-year-old man with a medical history of rheumatoid arthritis, acute coronary syndrome, and diabetes was admitted to our hospital because of left chest pain and dyspnea. Read More

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Development and validation of response markers to predict survival and pleurodesis success in patients with malignant pleural effusion (PROMISE): a multicohort analysis.

Lancet Oncol 2018 07 13;19(7):930-939. Epub 2018 Jun 13.

Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Laboratory of Pleural and Lung Cancer Translational Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Oxford Respiratory Trials Unit, Nuffield Department of Medicine, University of Oxford, Oxford, UK; National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.

Background: The prevalence of malignant pleural effusion is increasing worldwide, but prognostic biomarkers to plan treatment and to understand the underlying mechanisms of disease progression remain unidentified. The PROMISE study was designed with the objectives to discover, validate, and prospectively assess biomarkers of survival and pleurodesis response in malignant pleural effusion and build a score that predicts survival.

Methods: In this multicohort study, we used five separate and independent datasets from randomised controlled trials to investigate potential biomarkers of survival and pleurodesis. Read More

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Malignant Pleural Effusion: From Diagnostics to Therapeutics.

Clin Chest Med 2018 03 13;39(1):181-193. Epub 2017 Dec 13.

Respiratory Medicine, Oxford University Hospitals, Churchill Hospital, Old Road, Headington, Oxford OX3 7LE, Great Britain. Electronic address:

Malignant pleural effusion is a common complication of cancer and denotes a poor prognosis. It usually presents with dyspnea and a unilateral large pleural effusion. Thoracic computed tomography scans and ultrasound are helpful in distinguishing malignant from benign effusions. Read More

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Consideration of underlying causes of pneumothoraces in patients presenting with their first pneumothorax.

J Intensive Care Soc 2017 Nov 10;18(4):334-338. Epub 2017 Jul 10.

Blackpool Victoria Hospital, Lancashire, UK.

We report a case of cardiac arrest secondary to pneumothorax. The patient failed to improve, and further investigation showed an underlying condition predisposing the patient to the development of pneumothoraces - lymphangioleiomyomatosis. This highlights the importance of follow-up and investigation in patients presenting with their first pneumothorax. Read More

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November 2017

Surgical and non-surgical management of malignant pleural effusions.

Expert Rev Respir Med 2018 01 9;12(1):15-26. Epub 2017 Nov 9.

a School of Medicine & Pharmacology , University of Western Australia , Crawley , WA , Australia.

Introduction: Optimal management of malignant pleural effusion (MPE) is important in the care of patients with advanced cancer. Surgical (especially video-assisted thoracoscopic surgery (VATS)) and non-surgical strategies are available. Clinicians should be aware of the evidence supporting the use of different modalities to guide treatment choice. Read More

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January 2018

[Malignant Pleural Mesothelioma Presenting Refractory Pneumothorax Successfully Treated by Intrapleural Administration of Diluted Fibrin Glue;Report of a Case].

Kyobu Geka 2017 May;70(5):393-396

Department of Thoracic, Endocrine Surgery and Oncology, University of Tokushima Graduate School, Tokushima, Japan.

Malignant pleural mesothelioma sometimes accompanies intractable neumothorax due to the visceral pleural invasion of the tumor. A 68-years-old man was found to have massive pleural effusion and pleural mass combined with pneumothorax by computed tomography(CT). CT guided biopsy revealed the mass to be malignant pleural mesothelioma. Read More

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Standardizing Robotic Lobectomy: Feasibility and Safety in 128 Consecutive Lobectomies Within a Single Healthcare System.

Innovations (Phila) 2017 Mar/Apr;12(2):77-81

From the *Division of Thoracic Surgery, PinnacleHealth CardioVascular Institute, Harrisburg, PA USA; †Division of Cardiothoracic Surgery, Northwell Health, Manhasset, NY USA; and ‡Division of Cardiothoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, NY USA.

Objective: Single-surgeon cohorts assessing robotically assisted video-assisted thoracic (RA-VATS) lobectomy have reported good outcomes, but there are little data regarding multiple surgeons applying a standard technique in separate hospitals. The purpose of this study was to show how a standardized robotic technique is both safe and reproducible between surgeons and institutions.

Methods: From July 1, 2012, to October 1, 2013, patients undergoing RA-VATS lobectomy for both benign and malignant disease were identified from a prospectively collected database of two thoracic surgeons from different hospitals within the same healthcare system and retrospectively analyzed. Read More

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September 2017

Surgical Intervention for Primary Spontaneous Pneumothorax in Pediatric Population: When and Why?

J Laparoendosc Adv Surg Tech A 2017 Aug 18;27(8):841-844. Epub 2017 Jan 18.

Division of Paediatric Surgery, Department of Surgery, University of Hong Kong Medical Center , Queen Mary Hospital, Hong Kong, China .

Introduction: Spontaneous pneumothorax in pediatric patients is relatively uncommon. The management strategy varies in different centers due to dearth of evidence-based pediatric guidelines. In this study, we reviewed our experience of thoracoscopic management of primary spontaneous pneumothorax (PSP) in children and identified risk factors associated with postoperative air leakage and recurrence. Read More

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The role of thoracic surgery in the management of mesothelioma: an expert opinion on the limited evidence.

Expert Rev Respir Med 2016 06 18;10(6):663-72. Epub 2016 Apr 18.

b Division of Thoracic Surgery , Glenfield Hospital , Leicester , UK.

Surgery has a key role at different points in the management of Malignant Pleural Mesothelioma. Diagnosis with video assisted thoracoscopy offers excellent sensitivity and specificity and a direct view of the pleural cavity to verify the extent of the tumor. Nodal involvement can be assessed by mediastinoscopy and either talc pleurodesis or partial pleurectomy can be used for symptom control in advanced stage disease. Read More

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Uniportal video assisted thoracoscopic surgery bullectomy and double pleurodesis for primary spontaneous pneumothorax.

Adrian Ooi Zhu Ling

J Vis Surg 2016 26;2:17. Epub 2016 Jan 26.

Department of Cardiothoracic Surgery, National Heart Centre Singapore, Singapore.

Background: Primary spontaneous pneumothorax (PSP) usually occurs in young adults, with higher incidence in smoker, and patients with narrow chest frame and slim body habitus. Surgery is indicated in the cases of recurrence episodes or persistent lung collapse, and failed conservative management by chest drain insertion. Video assisted thoracoscopic surgery (VATS) bullectomy and pleurodesis is the surgical treatment of choice but uniportal approach has been utilised to further minimise surgical trauma, improve cosmesis without compromising the efficacy of the procedure. Read More

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January 2016

Hypertonic glucose pleurodesis and surgical diaphragmatic repair for tension hydrothorax complicating continuous ambulatory peritoneal dialysis.

Clin Nephrol 2016 May;85(5):301-4

We herein describe a case of tension hydrothorax that occurred on continuous ambulatory peritoneal dialysis (CAPD), highlighting the problems of diagnosis and a novel management. A 38-year-old male with end-stage renal disease (ESRD) due to diabetes mellitus developed dyspnea and poor drainage after 13 months of CAPD. Chest X-ray revealed massive right-sided hydrothorax and mediastinal shift. Read More

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Effect of Opioids vs NSAIDs and Larger vs Smaller Chest Tube Size on Pain Control and Pleurodesis Efficacy Among Patients With Malignant Pleural Effusion: The TIME1 Randomized Clinical Trial.

JAMA 2015 Dec 22-29;314(24):2641-53

Research Department of Infection and Population Health, Institute of Epidemiology and Healthcare, University College London, London, England.

Importance: For treatment of malignant pleural effusion, nonsteroidal anti-inflammatory drugs (NSAIDs) are avoided because they may reduce pleurodesis efficacy. Smaller chest tubes may be less painful than larger tubes, but efficacy in pleurodesis has not been proven.

Objective: To assess the effect of chest tube size and analgesia (NSAIDs vs opiates) on pain and clinical efficacy related to pleurodesis in patients with malignant pleural effusion. Read More

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February 2016

Life-threatening pleural hemorrhage following intrapleural enzyme therapy and successful treatment with fibrin-thrombin sealant pleurodesis: a case report.

J Med Case Rep 2015 Dec 18;9:287. Epub 2015 Dec 18.

Cardiac and Thoracic Surgical Unit, Flinders University, Sturt Road, Bedford Park, SA, 5042, Australia.

Introduction: Intrapleural fibrinolytic enzyme therapy is a potentially surgery-sparing treatment for poorly resolving parapneumonic effusion and empyema. It is safe in the majority of patients, however the most significant risk associated with this treatment is severe bleeding secondary to pleural hemorrhage. Contraindications for intrapleural enzyme therapy are not widely agreed upon and little is known about how to treat this difficult and potentially lethal hemorrhagic complication. Read More

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December 2015