[Palliative treatment of malignant effusions by thoracoscopy under video-assistance: morbidity and survival]

Survival after surgical palliation of patients with malignant pleural effusions is expected to be of several months. From a group of 75 patients operated by video-assisted thoracic surgery (VATS) from September 1991 through March 1993, twenty-two of 38 patients with malignant disease underwent palliative surgery and operative morbidity and length of survival were studied. Palliation consisted in 20 talc pleurodesis and 2 pericardial windows for malignant effusions. In the 16 other patients with malignancy, video-thoracoscopy was done for diagnostic purposes. Thirty-day operative mortality was 13.6% (3/22) and the rate of operative morbidity was 31.8% (7/22). The follow-up was complete for all patients with a mean length of 5 months (+/- sd 4 months). During the follow-up period, 14 of 19 (74%) patients, alive 30 days after the procedure, were deceased at a mean of 3.4 +/- 4 months (6 patients < 3 months) after the operation. In all, 9 of 22 patients (40%) survived less than 3 months (median survival 4 months). Operative morbidity and mortality of video-thoracoscopy are high in the palliative group and only 60% of patients survived more than 3 months. More stringent criteria for selection of patients for palliative endosurgery should be defined.