Strategy optimization and modified pleurodesis in treatment of patients with resistant pleural effusion

Pleural effusion critically reduces the quality of life. To prevent life-threatening complications, pleural puncture is performed. In case of pleural effusion resistant to drainage, the pleural cavity is usually obliterated. Research aimed at improving pleurodesis management remains relevant. Objective: The aim of the study is to improve treatment outcomes in patients with resistant pleural effusion by optimizing the timing of surgery and using a new method of pleurodesis induction. Materials and Methods: At the first stage, 68 patients with resistant pleural effusion and 61 patients with effective pleural drainage were compared. At the second stage, patients with resistant pleural effusion underwent pleurodesis: Group 1 (n=33) – on the 7th day according to S.A. Plaksin and L.I. Farshatova method, Group 2 (n=35) – according to a proprietary know-how method. The authors used Fisher's exact two-tailed test and Student's t-test for unrelated samples. Results. In patients with resistant pleural effusion, the primary tumor is predominantly localized in the mammary gland with lymph node involvement, stage N1 or higher, and metastases, stage M1 or higher. At the second stage of the study, it was found that in the second subgroup of the first group of patients, the painfulness of the procedure was significantly reduced; the drainage duration was reduced by 2.6 times; the length of hospital stay was reduced by 2.2 days; a significant decrease in the level of total protein was excluded, and quality of life indicators improved 1 month after pleurodesis. Conclusion. Reducing the time of decision-making on pleurodesis, based on the study of risk factors for the development of resistant pleural effusion, and the use of a know-how technique can significantly im-prove the treatment results and the course of the immediate postoperative period.