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

Abstract

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.

Diagnosis and management of malignant pleural effusions: state of the art in 2017

“…TPC related pleurodesis has been reported to occur between 29 to 59 days post placement (72,77,78 (79). In a recent randomized trial, Impact of Aggressive versus Standard Drainage Regimen Using a Long-Term Indwelling Pleural Catheter trial (ASAP trial), rates of spontaneous pleurodesis were higher in patients daily drainage compared to the every other day drainage of pleural fluid via a TPC (47% vs. 24%, respectively; P = 0.003).…”

A comparison of chemical pleurodesis using 8 f percutaneous catheter and 28 f chest tube thoracostomy in malignant pleural effusions

“…15 Many centres use chemical sclerotherapy with percutaneous catheters as the first choice treatment option in MPE. 16,17 However, there has always been the problem that obstruction of the narrow diameter occurs easily. Kiliç et al recommended the use of Cystofix catheter because of the problem of obstruction in 8F catheters.…”

Managing malignant pleural effusion with an indwelling pleural catheter: factors associated with spontaneous pleurodesis

“…Previous studies suggest that up to 20.6% (range, 1.6-20.6%) of IPCs need to be removed due to complications. [9][10][11]14,15,21,22 Nonetheless, serious complications are uncommon; the most common being pleural infection (0-16.7%). 23 The TIME2 study reported that the risk of pleural infection was 13.4% in the IPC group compared with 1.9% in the talc slurry pleurodesis group.…”