Author of

• 15530

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  P3.06 - Poster Session/ Screening and Early Detection (ID 220)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Screening and Early Detection
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 15553

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    P3.06-023 - Optimizing Lung Cancer, Utility of Early Thoracoscopy vs Thoracocentesis (ID 210)

    09:30 - 09:30  |  Author(s): L.S. Nieto
    • Abstract

    Background:
    INTRODUCTION Prospective study from the work group in thoracic oncology in Hidalgo Mexico Lung cancer Still first cause of dead for cancer in wordlwide. Diagnosis, prevalence and therapeutic approach apperece directly with their clinic manifestation and deppends on economic an sociocultural patients behave. Being a non cover pathology by the State the patient has to pay all management and doctors visit. Eventhough hospital structure
    
    Methods:
    Retrospective study from january 2012 to december 2014 in Mexico including patients from public attendance and private all of them with autorized consecent We include 100 patients with massive pleural effusion, lung cancer risk factors like age more tan 50 years old, tabacco use with approximatly 30 annual package, Wood smoke 100 hr / year, work activity in mines, construction, masonry, or asbestos fibers at home or work. Sample include 54 male and 46 female. Diagnostic Thoracocentesis was done in all 100 patients with an amount of pleural effusion with range between 2.5 ml to 2500ml, aspect yellow to hematic an average of 248.6 ml. Only 8 patients (8%) Has oncologic diagnosis in pleural effusion; 40 patients (40%) with diagnosis in pleural tissue including 37 patients (37%) cáncer diagnosis and 3 patients (3%) tuberculousis. The rest 52 patients (52%) only mesothelial reaction in first thoracocentesis. From the 100 patients 60% do not return to confirm diagnosis or to reevaluate at 2 weeks with chest X ray and to explain first pathologic result arguing not having time, no money and no necesary if the first one was no cancer.
    
    Results:
    The present study shows how only in 8% can get in an oncologic diagnosis in pleural liquid in a thoracic reference hospital, on the other hand patients that had a complete protocol with a CT scan after thoracocentesis, and surgical intervention with thoracoscopy and pleural biopsy we can achieve an oncologic diagnosis in 29%, in patients with clinical features and risk factors for lung cancer. 29 patients that underwent single port thoracoscopy were previously rated for cardiovascular risk by a cardiologist, and for respiratory hazard by a pulmonologist. Surgical time varied from 1 to 2 hours, hospital stay was 2 to 5 days, those patients that persisted with high output from thoracic catheter tunneled were treated ambulatory and weekly consultation until chest tube withdrawal.
    
    Conclusion:
    Our study shows how a patient with a massive pleural effusion, with clinical data and risk factors for lung cancer, can get an oncological diagnosis by single port thoracoscopy as initial approach, with surgical staging, giving a quick resolution, and in selected cases offer a palliative treatment by a thoracic catheter tunneled and chemical pleurodesis, if indicated after making serial samples for histological study. Offering a resolutive treatment and a prompt diagnosis in a pathology that is increasing and with no satisfaying results in developing countries were a strict follow in many cases is no posible