!Objective: In patients with malignant effusions and ECOG 3 -4 or unexpandable lung, the PleurX ® catheter system provides an effective at-home palliation of symptoms associated with recurrent pleural effusions. We investigated the clinical results of patients treated by this method in our population. Methods: All patients treated with PleurX between June 2005 and September 2010 in our clinical center were recorded using a predefined data sheet. Primary points of interest were complications associated with the insertion procedure, short-and long-term complications after insertion of the catheter, the rate of pleurodesis, the frequency of hospitalizations due to effusionassociated symptoms, time of drainage and survival time after insertion. In order to assess follow-up, a standardized questionnaire was sent to the attending practitioners. Results: Pleural effusions were most frequently due to lung cancer, breast cancer and mesothelioma. The rate of compilations associated with the insertion procedure was 7 %, and complications could easily be managed. The rate of short-term complications after insertion of the catheter was 7 %, and of long-term compilations 18 %. The rate of pleurodesis was 16 %. 78 % of patients did not need another hospitalization due to effusionrelated symptoms. The mean time of drainage was 52 days. The mean survival after insertion of the drainage was 76 ± 85 days (1 -453). Conclusions: The insertion of a PleurX catheter is associated with a low complication rate. Shortterm and long-term complications are usually mild and can be readily managed. Hospitalizations due to effusion-related symptoms were not necessary in the majority of patients.Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages.
Einleitung
A 44-year-old female patient presented with an extensive exacerbation of severe chronic obstructive lung disease (COPD) and bullous emphysema. Because of a severe type II respiratory failure, the patient was intubated and mechanically ventilated. Respiratory failure was refractory despite appropriate ventilation regimes and pCO2 values ranged from 110 mm Hg to 180 mm Hg. Chest radiography revealed hyperinflation of two giant bullae with mediastinal shifting to the left lung. We describe a successful rescue bullectomy.
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