Estudio comparativo del uso de agentes fibrinoliticos frente a la cirurgia en el tratamiento del derrame pleural complicado

Identificador:  TDX:633

Handle: https://hdl.handle.net/20.500.11797/TDX633

Autores:  Albort Ventura, Jesús

Resumen:
STUDY OBJECTIVES: To determine the optimal treatment of complicated pleural effusion comparing pleural drainage and fibrinolytic therapy ( urokinase ) versus videoassisted thoracoscopic surgery (VATS), with regard to efficacy and duration of hospitalization. DESIGN: 186 patients with confirmed complicated pleural effusion were controlled to chest tube pleural drainage plus urokinase (UK) vs VATS. PATIENTS AND METHODS: Equivalent groups of patients with complicated pleural effusion were choosed to receive either of two therapies: UK (n = 113) or VATS (n = 73). The two groups of patients had similar characteristics. Mean age was 60,2 years (range:19-82 years). Outcomes analysis with respect to treatment efficacy, hospital duration, chest tube duration, hospital costs, and need for subsequent procedures was performed. RESULTS: When compared with the VATS group, the UK group had a significantly higher primary treatment success, lower chest tube duration, and lower number of total hospital days ( p < 0.05). Clinically relevant and statistically significant differences in hospital costs also favored the UK group. CONCLUSIONS: In patients with complicated pleural effusion, a primary treatment strategy of UK is associated with a higher efficacy, shorter hospital duration, and less cost than a treatment strategy that utilizes surgery