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Vol. 30. Issue 1.
Pages 16-18 (January 1994)
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Vol. 30. Issue 1.
Pages 16-18 (January 1994)
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Descripción de un método para practicar toracocentesis evacuadoras repetidas en pacientes con derrame pleural maligno no tratable
Description of a method for performing repeated evacuating thoracocentesis in patients with untreatable malignant pleural effusion
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G. Varela*
Servicio de Cirugía Torácica. Hospital Universitario 12 de Octubre. Madrid
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Mediante el implante subcutáneo de un sistema de acceso diseñado en principio para el peritoneo, cuyo catéter se tuneliza desde el tejido subcutáneo torácico hasta la cavidad pleural, se pueden realizar drenajes repetidos con mínimo riesgo para el paciente, en casos de derrame pleural maligno recidivante que no ha podido ser tratado por otros procedimientos.

Se describe la experiencia inicial en 3 pacientes con neoplasias avanzadas no tratables, que han podido recibir tratamiento sintomático de la disnea gracias a este método durante un período de tiempo entre uno y 4 meses, de forma ambulatoria. No se han registrado complicaciones salvo la obstrucción parcial de un catéter que pudo ser desobstruido con urocinasa.

Repeated drainage by thoracocentesis may be carried out in patients with untreatable malignant pleural effusion by subcutaneous insertion of an access System initially designed for the peritoneum. The catheter is inserted into the pleural cavity through thoracic tissue, facilitating repeated drainage with minimum risk for the patient with recurring malignant pleural effusion who is no longer eligible for other therapeutic procedures.

We describe our initial experience in three patients with untreatable advanced neoplasms who received symptomatic treatment for dysnea with this method on an out-patient basis for a period of between one to four months. No complications were observed except for partial obstruction of a catheter which was unblocked with urokinase.

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Bibliografía
[1.]
A. Cantó, J. Rivas, J. Moya, J. Saumench, J. Poch, R. Morera, et al.
Derrames pleurales de etiología maligna. Utilización del talco mediante toracoscopia como método eficaz de pleurodesis.
Med Clin (Barc), 84 (1985), pp. 806-808
[2.]
A.J. Zaloznik, S.G. Oswald, M. Laugin.
Intrapleural tetracycline in malignant pleural effusions. A randomized study.
Cancer, 51 (1983), pp. 752-755
[3.]
G. Varela, P. De Pablo, M.J. Ruiz.
Pleurodesis con tetraciclina en derrames neoplásicos. ¿Es necesario un pH ácido?.
Rev Med Univ Nav, 32 (1988), pp. 143-146
[4.]
S.A. Sahn.
Cells proteins and the acid-base status of pleural fluid in health and disease.
Diseases of the pleura, pp. 120-130
[5.]
V. Tsang, H.C. Fernando, P. Goldstraw.
Pleuroperitoneal shunt for recurrent malignant pleural effusions.
Thorax, 45 (1990), pp. 369-372
Copyright © 1994. Sociedad Española de Neumología y Cirugía Torácica
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