Supplementary Material for: Pleurodesis Using Mistletoe Extract Delivered via a Spray Catheter during Semirigid Pleuroscopy for Managing Symptomatic Malignant Pleural Effusion

<b><i>Background:</i></b> Talc poudrage during thoracoscopy is considered the standard procedure for patients with symptomatic malignant pleural effusion (MPE). Until now, no alternative technique other than talc poudrage for pleurodesis during medical thoracoscopy has been proposed. Liquid sclerosants, such as mistletoe extract, have been sprayed evenly into the pleural cavity during semirigid pleuroscopy for chemical pleurodesis. <b><i>Objective:</i></b> We conducted a retrospective study using the database of semirigid pleuroscopy to identify the usefulness of pleurodesis using a mistletoe extract delivered via a spray catheter during semirigid pleuroscopy for symptomatic MPE. <b><i>Methods:</i></b> All consecutive patients with symptomatic MPE who underwent semirigid pleuroscopy from October 2015 to September 2016 were registered. The responses were evaluated using chest X- ray or computed tomography 4 weeks after pleurodesis. <b><i>Results:</i></b> The study included 43 patients who underwent pleurodesis with mistletoe extract via a spray catheter during semirigid pleuroscopy. Complete and partial responses were seen in 21 (49%) and 19 (44%) patients, respectively. The median duration of chest tube placement after pleurod­esis was 7 days (range 6–8 days) in the 40 patients with complete or partial responses. No cases of severe hemorrhage, empyema formation, respiratory failure, or procedure-related mortality were observed in the subjects at 4 weeks after semirigid pleuroscopy. <b><i>Conclusion:</i></b> Pleurodesis with mistletoe extract delivered via a spray catheter during semirigid pleuroscopy is a safe and effective procedure for managing symptomatic MPE.

<b><i>背景：</i></b> 胸腔镜术中滑石粉喷撒术（talc poudrage）被视为有症状恶性胸腔积液（Malignant Pleural Effusion, MPE）患者的标准诊疗操作。迄今为止，医学胸腔镜术中除滑石粉喷撒术外，尚无其他用于胸膜固定术（pleurodesis）的替代技术。诸如槲寄生提取物（mistletoe extract）类的液体硬化剂，已在半硬质胸腔镜检查术（semirigid pleuroscopy）中被均匀喷洒至胸膜腔，以实施化学胸膜固定术。
<b><i>目的：</i></b> 本研究依托半硬质胸腔镜检查术数据库开展回顾性分析，旨在探讨半硬质胸腔镜检查术中经喷撒导管注入槲寄生提取物实施胸膜固定术，对有症状恶性胸腔积液患者的临床应用价值。
<b><i>方法：</i></b> 本研究纳入2015年10月至2016年9月期间，所有接受半硬质胸腔镜检查术的有症状恶性胸腔积液连续患者。于胸膜固定术后4周，通过胸部X线或计算机断层扫描（Computed Tomography, CT）评估治疗应答情况。
<b><i>结果：</i></b> 本研究共纳入43例于半硬质胸腔镜检查术中经喷撒导管注入槲寄生提取物实施胸膜固定术的患者。其中完全应答与部分应答患者分别为21例（49%）与19例（44%）。在获得完全或部分应答的40例患者中，胸膜固定术后胸腔闭式引流的中位留置时长为7天（范围6~8天）。半硬质胸腔镜检查术后4周内，未观察到严重出血、脓胸（empyema）形成、呼吸衰竭（respiratory failure）或与操作相关的死亡病例。
<b><i>结论：</i></b> 半硬质胸腔镜检查术中经喷撒导管注入槲寄生提取物实施胸膜固定术，是治疗有症状恶性胸腔积液的安全且有效的诊疗方案。