Tunneled Pleural Catheters for Palliation of Malignant Pleural Effusions

Michaud, Ga tane; Barclay, Patricia; Tremblay, Alain

doi:10.1097/01.lab.0000185782.99433.02

Cited by 8 publications

(11 citation statements)

References 7 publications

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“…Recently, the use of TPCs has been described as a successful treatment for MPE [7][8][9][10][11][12][13][14][15][16]. The current authors' experience with this technique suggests that high rates of symptom control can be achieved on an outpatient basis and with minimal complications [8,11,16].…”

Section: Discussionmentioning

confidence: 86%

“…The current authors' experience with this technique suggests that high rates of symptom control can be achieved on an outpatient basis and with minimal complications [8,11,16]. There is little doubt that this technique should be considered in the management of patients with MPE and trapped lung syndrome [7] or short life expectancy and poor functional status.…”

Section: Discussionmentioning

confidence: 99%

“…Details regarding the clinical approach taken within the current study for the TPC procedure, the design of the database and overall results have been published previously [11,16]. All patients were instructed on catheter use and referred to a palliative nursing homecare programme for assistance with catheter maintenance and drainage.…”

Section: Study Subjectsmentioning

confidence: 99%

“…However, each of these methods is associated with significant morbidity and risk of mortality, whilst the impact on quality of life and symptom control has rarely been reported with these techniques. An alternative method of palliating MPE involves the use of tunnelled pleural catheters (TPC), which are inserted on an outpatient basis and have minimal associated risks or complications [7][8][9][10][11][12][13][14][15][16]. However, critics of this procedure suggest it should only be offered to patients not considered for pleurodesis procedures [17,18].…”

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confidence: 99%

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Use of tunnelled catheters for malignant pleural effusions in patients fit for pleurodesis

Tremblay¹,

Mason²,

Michaud³

2007

European Respiratory Journal

109

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The aim of the present study was to examine the effectiveness of tunnelled pleural catheters (TPC) in patients with malignant pleural effusions who would otherwise be candidates for pleurodesis.Patients were selected from a previously reported database of 250 TPC insertions. The study group was selected based on lung re-expansion and survival as a surrogate maker of eligibility for pleurodesis procedure, as defined by survival of o90 days and lung re-expansion o80% postdrainage on a standard chest radiograph 2 weeks post TPC placement.There were 109 procedures in 97 patients that met the entry criteria. Spontaneous pleurodesis (SP) was achieved following 70% of procedures and correlated with symptom control. The mean time to SP was 90 days. There was no need for a repeat procedure in 87% of cases overall and in 92% of patients experiencing SP. There were few complications and no procedure-related deaths.Tunnelled pleural catheters are an effective way of controlling malignant pleural effusions when used as first-line treatment in patients who appear to be candidates for pleurodesis procedures.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Study Subjectsmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Use of tunnelled catheters for malignant pleural effusions in patients fit for pleurodesis

Tremblay¹,

Mason²,

Michaud³

2007

European Respiratory Journal

109

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“…The tunneled pleural catheter system most commonly used (Pleurx; Denver Biomedical, Denver, Colorado, USA) consists of a 24 in long, 15.5 Fr silicone tube that has a fenestrated distal end and a valve for draining purposes at the proximal end [23 ]. The mid portion of the tube has a polyester cuff that holds the tunneled portion just beneath the skin, and acts as a barrier to infection.…”

Section: Tunneled Pleural Cathetersmentioning

confidence: 99%

Use of tunneled pleural catheters for outpatient treatment of malignant pleural effusions

Stather

Tremblay²

2007

Current Opinion in Pulmonary Medicine

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Efficacy and Safety of Tunneled Pleural Catheters in Adults with Malignant Pleural Effusions: A Systematic Review

2010

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BackgroundMalignant pleural effusions (MPE) are a frequent cause of dyspnea and discomfort at the end of cancer patients' lives. The tunneled indwelling pleural catheter (TIPC) was approved by the FDA in 1997 and has been investigated as a treatment for MPE.ObjectiveTo systematically review published data on the efficacy and safety of the TIPC for treatment of MPE.DesignWe searched the MEDLINE, EMBASE, and ISI Web of Science databases to identify studies published through October 2009 that reported outcomes in adult patients with MPE treated with a TIPC. Data were aggregated using summary statistics when outcomes were described in the same way among multiple primary studies.Main MeasuresSymptomatic improvement and complications associated with use of the TIPC.Key ResultsNineteen studies with a total of 1,370 patients met criteria for inclusion in the review. Only one randomized study directly compared the TIPC with the current gold standard treatment, pleurodesis. All other studies were case series. Symptomatic improvement was reported in 628/657 patients (95.6%). Quality of life measurements were infrequently reported. Spontaneous pleurodesis occurred in 430/943 patients (45.6%). Serious complications were rare and included empyema in 33/1168 patients (2.8%), pneumothorax requiring a chest tube in 3/51 (5.9%), and unspecified pneumothorax in 17/439 (3.9%). Minor complications included cellulitis in 32/935 (3.4%), obstruction/clogging in 33/895 (3.7%) and unspecified malfunction of the catheter in 11/121 (9.1%). The use of the TIPC was without complication in 517/591 patients (87.5%).ConclusionsBased on low-quality evidence in the form of case series, the TIPC may improve symptoms for patients with MPE and does not appear to be associated with major complications. Prospective randomized studies comparing the TIPC to pleurodesis are needed before the TIPC can be definitively recommended as a first-line treatment of MPE.

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Tunneled Pleural Catheters for Palliation of Malignant Pleural Effusions

Cited by 8 publications

References 7 publications

Use of tunnelled catheters for malignant pleural effusions in patients fit for pleurodesis

Use of tunnelled catheters for malignant pleural effusions in patients fit for pleurodesis

Use of tunneled pleural catheters for outpatient treatment of malignant pleural effusions

Efficacy and Safety of Tunneled Pleural Catheters in Adults with Malignant Pleural Effusions: A Systematic Review

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