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Pleuro-peritoneal shunting. Alternative therapy for pleural effusions.

Publication ,  Journal Article
Little, AG; Kadowaki, MH; Ferguson, MK; Staszek, VM; Skinner, DB
Published in: Ann Surg
October 1988

Pleural effusions are resistant to standard therapy, which causes discomfort and can require prolonged hospitalization. As an alternative, pleuroperitoneal shunting for pleural effusions of various etiologies was evaluated. We implanted 36 shunts in 29 patients. Two patients had bilateral shunts and five had shunt revisions. The effusion was related to a malignancy in 22 patients, postoperative chylothorax in two patients, and other causes in five patients. Therapeutic thoracentesis had been attempted in 28 patients, and eight had had chest tube placement previously with attempted sclerosis. Seven patients had a trapped lung syndrome. There was no operative mortality. All patients were deemed ready for discharge from the hospital if they had recovered from the operation within 48 hours. Five patients had poor results, either because of a moribund status or their refusal or inability to pump the shunt. Of the remaining 24 patients, four had good results with temporary improvement, and excellent results were achieved in 20 patients (83.3%), who experienced symptomatic relief and stabilization or regression of pleural effusion until the time of their death. Patients with chylothorax experienced complete resolution. The 14 patients with malignant effusions had a median survival of 4 months, and there were no instances of peritoneal tumor seeding. In conclusion, pleuroperitoneal shunting is an alternative therapy for pleural effusions that requires a limited hospitalization only, is associated with minimal and short-term discomfort, achieves excellent results in properly selected patients, and is the only viable therapy when lung expansion cannot be achieved.

Duke Scholars

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

October 1988

Volume

208

Issue

4

Start / End Page

443 / 450

Location

United States

Related Subject Headings

  • Surgery
  • Radiography
  • Pleural Effusion
  • Peritoneal Cavity
  • Middle Aged
  • Male
  • Humans
  • Female
  • Catheterization
  • Aged, 80 and over
 

Citation

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Little, A. G., Kadowaki, M. H., Ferguson, M. K., Staszek, V. M., & Skinner, D. B. (1988). Pleuro-peritoneal shunting. Alternative therapy for pleural effusions. Ann Surg, 208(4), 443–450. https://doi.org/10.1097/00000658-198810000-00006
Little, A. G., M. H. Kadowaki, M. K. Ferguson, V. M. Staszek, and D. B. Skinner. “Pleuro-peritoneal shunting. Alternative therapy for pleural effusions.Ann Surg 208, no. 4 (October 1988): 443–50. https://doi.org/10.1097/00000658-198810000-00006.
Little AG, Kadowaki MH, Ferguson MK, Staszek VM, Skinner DB. Pleuro-peritoneal shunting. Alternative therapy for pleural effusions. Ann Surg. 1988 Oct;208(4):443–50.
Little, A. G., et al. “Pleuro-peritoneal shunting. Alternative therapy for pleural effusions.Ann Surg, vol. 208, no. 4, Oct. 1988, pp. 443–50. Pubmed, doi:10.1097/00000658-198810000-00006.
Little AG, Kadowaki MH, Ferguson MK, Staszek VM, Skinner DB. Pleuro-peritoneal shunting. Alternative therapy for pleural effusions. Ann Surg. 1988 Oct;208(4):443–450.

Published In

Ann Surg

DOI

ISSN

0003-4932

Publication Date

October 1988

Volume

208

Issue

4

Start / End Page

443 / 450

Location

United States

Related Subject Headings

  • Surgery
  • Radiography
  • Pleural Effusion
  • Peritoneal Cavity
  • Middle Aged
  • Male
  • Humans
  • Female
  • Catheterization
  • Aged, 80 and over