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Ann Thorac Surg 1979;28:190-203
© 1979 The Society of Thoracic Surgeons

Articles

The Treatment of Recurrent Malignant Pleural Effusion

Erle H. Austin, M.D.*, M. Wayne Flye, M.D.

From the Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD

* Address reprint requests to Dr. Austin, Surgery Branch, National Cancer Institute, Building 10, Room 10N116, Bethesda, MD 20014

Effective control of a recurrent malignant pleural effusion can greatly improve the quality of life of the cancer patient. At least a dozen different techniques have been advocated for controlling this common complication of malignant disease. The present review collects and examines the clinical results of all techniques designed to treat this problem. The pathophysiology and diagnostic evaluation of the effusion are also discussed.

On the basis of comparisons involving effectiveness, morbidity, and convenience, we recommend intrapleurally administered tetracycline with thoracostomy drainage as the technique of choice. Instillation of a talc suspension with thoracostomy drainage is also a safe and effective technique and should be employed when tetracycline fails or is contraindicated.




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