[Pleuroperitoneal shunt for malignant pleural effusions]

The malignant pleural effusion was introduced into the abdominal cavity by the manual compression of a pleuroperitoneal shunt tube, which was indwelt in the subcutaneous tissue of the lateral chest under local anesthesia. Seven patients having malignant pleural effusion, due to lung cancer in 4 and breast cancer in 3, were used as subjects. This technique caused no serious complications. Retention of pleural effusion was markedly reduced in all of the 7 patients. Three patients, whose performance status (P.S.) was preoperatively determined to be 3 or 2, could be discharged during early periods. This technique seemed to be highly feasible in these patients, but not in those having P.S. of 4. Since peritoneal dissemination of the tumor was seen in 1 of 3 patients examined by autopsy, there is a possibility that this technique might have contributed to spread and scattering of tumor cells in the peritoneal cavity. These results suggested that this technique is useful therapeutic means for the treatment of patients in whom hospitalization is necessary due to the presence of malignant pleural effusion, while this technique involves the risk of artificial induction of peritoneal dissemination of tumor cells. Therefore, the application of this technique should be decided based on the prognosis of each patient.