Comparison of Success Rates of Pleurodesis with Talc, and Holmium-YAG Laser in the Patients with Malignant Pleural Effusion

Abstract

Objective: We aimed to investigate the efficacy of Holmium-yttrium aluminum garnet (Ho-YAG) laser using video assisted thoracoscopic surgery (VATS) and compare it with the talcslurry pleurodesis in patients with malignant pleural effusion (MPE).Methods: A total of 51 patients with MPE were included. Patients were divided into two groups. In the laser group, pleurodesis was attempted using Ho-YAG laser through auniportal VATS in 30 patients; in the talc group, pleurodesis was attempted using talc slurry through a small bore chest tube in 21 patients. The success rate of pleurodesis was evaluated using chest X-ray and/or thorax computed tomography obtained at the second month following pleurodesis and was graded as total success, partial success, or failure.Results: In the laser group, pleurodesis was a total success in 19 (63%) patients and partial in 7 (23%) patients. The volume of pleural effusion drained postoperatively was significantly different between the success subgroups (total success subgroup vs. failure subgroup, p=0.000; partial success subgroup vs. failure subgroup, p=0.001). In the talc group, pleurodesis was a total success in 11 (52%) patients and partial in 6 (29%) patients. The success rates of pleurodesis between the talc and laser groups showed no significant difference (p=0.725).Conclusion: The use of Ho-YAG laser through VATS is a safe and effective option for pleurodesis in the management of MPE. However, there is no difference between Ho-YAG laser and talc slurry pleurodesis in terms of procedure success rates.