The Recent Effect Of Video-assisted Thoracic Surgery To Treat The Non-small Cell Lung Cancer Patients With Malignant Pleural Effusion.

Objective To estimate the recent clinical effect of Video-assisted Thoracosopic Surgery in treating the Non-small Cell Lung Cancer patients with Malignant Pleural Effusion.Methods Retrospect analysis of 166 cases diagnosed NSCLC with MPE in VATS from October 2009 to October 2010 in our hospital and divide them into three groups by different treatments. Group A: 64cases treated with VATS--- 40 males and 24 females ranging from 39 to 82,average(57.34±13.23)years, 50 cases of adenocarcinomas and 14 cases of squamous cell carcinomas; Group B: 50 cases with intrapleural injections of Sapylin Injection ---24 males and 26 females ranging from 37 to 80 years, average (67.24±11.34) years, 34 adenocarcinomas cases and 16 squamous cell carcinomas cases; Group C: 52 cases with paracentesis of pleural effusion and chemo-treatment--- 32 males and 20 females ranging from 46 to 93 , average (70.77±14.21) years, 36 adenocarcinomas cases and 16 squamous cell carcinomas cases. Compare the three groups in curative effect , the quality of living ,the adverse reaction , the status of thoracic duct lymph drainage and the recurrence and death rate in the 6~12 months follow-up studies to evaluate the advantages and disadvantages of VATS in treating the NSCLC patients with malignant pleural effusion..Results①All groups were performed successfully and no patient died. As for the factors of sex, age ,the pathologic type and the components of chest fluid before cu- re, the differences of them have no statistical significance (P>0.05)making them com- parable .②Effects: As to the factors of sex and age , the differences of them have no statistical significance(P>0.05) and the cure of adenocarcinomas is more efficacious than that of squamous cell carcinomas with statistical sense(P<0.05).Group A is much better than Group B and C(P<0.05) and Group B better than Group C(P<0.05)which has statistical sense;③Untoward effects: Group A has much less untoward effects than Group B and C(P<0.05) and Group B less than C (P<0.05) with statistical significance ;④Condition after catheter drainage: Group A is less than Group B and C(P<0.05) and Group B less than C in amount(P<0.05)with statistical significance.But for days of catheter drainage Group A is less than C (P<0.05)while have no statistical significance with B(P>0.05).⑤The quality of living: Group A is superior to Group B and C(P<0.05) with statistical significance ;⑥In the 6~12 months follow-up studies,we can find that the relapse rate of Group A is obviously lower than the other two with 12 cases of death (1 case in A,4 in B and 7 in C) which shows statistical significance(P<0.05).Conclusion The effect of thoracoscopic surgery in treating malignant pleural effusion is much better than other groups .It is safe, effective, minimally invasive , painless and combines the diagnosis of pleural effusion and the treatment of malignant pleural effusion, taking the advantages of lower incidence rate of adverse reaction which largely helps improve the living standard of patients .In all, this method deserves to be applied widely to clinical use.