PleurX-Drainagekatheter zur palliativen Behandlung maligner Pleuraergüsse

Abstract

!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

The Treatment of Pleural Carcinosis With Malignant Pleural Effusion

“…In 26% to 58% of cases the use of this type of catheter even achieves spontaneous pleurodesis, so in many cases it has been possible to remove them (17,30,31). The rate of further effusion-related hospital stays is low (32). In most cases removal causes no problems, and complications (e.g.…”

The Malpositioned Tunneled Pleural Catheter

“…In addition to having the advantage of decreased hospital stay,3,4 they have been shown to have similar, if not better, safety profile than pleurodesis,3,5,6 higher success rate with achieving pleural drainage and lesser time to symptom improvement 7. It is also preferred over pleurodesis in patients with MPE and poor performance status and poor prognosis, as well as in patients with trapped lung 3…”

“…1 To our knowledge, only 7 cases of EBUS needle fracture have been described in published literature. [2][3][4][5][6][7][8] Here we report 2 cases of EBUS needle fracture that occurred at our institution in the same week.…”

Komplikationen nach pleuralem getunnelten Dauerkatheter bei symptomatischen rezidivierenden benignen und malignen Pleuraergüssen

“…Auftreten und Ausdehnung des Pneumothorax zeigten keinen Zusammenhang mit der Ergussdignität (p = 0,946), der Grunderkrankung (p = 0,688) und dem Operateur (n = 8; p = 0,497 [9 -19]. Der Anteil einer Katheterinfektion wird in gemischten Gruppen mit MPE und BPE in 3 retrospektiven Untersuchungen mit 1,3 -5,3 % [11,12,24], bei MPE in einer prospektiven und 4 retrospektiven Analysen mit 2,5 -9,6 % [10,14,16,17,20] sowie bei BPE in einem Review und 3 retrospektiven Studien mit 2,3 -16,1 % beschrieben [13,15,18,19]. Bemerkenswert ist eine in etwa gleich große deutschsprachige Untersuchung von Dilkaute et al an 69 Patienten [24].…”