Use of an Indwelling Pleural Catheter Compared with Thorascopic Talc Pleurodesis in the Management of Malignant Pleural Effusions

Ohm, Christina; Park, David; Vogen, Mary; Bendick, Phillip; Welsh, Robert; Pursel, Stewart; Chmielewski, Gary
March 2003
American Surgeon;Mar2003, Vol. 69 Issue 3, p198
Academic Journal
Therapy for recurrent malignant pleural effusion (MPE) is palliative. Video-assisted thoracic surgery with talc pleurodesis (VATS/TP) is limited to inpatients with completely expandable lung parenchyma. We evaluated the outcomes, safety, and efficacy of an indwelling pleural drainage catheter (PDC) system compared with VATS/TP. Forty-one consecutive patients with symptomatic MPE seen between September 2000 and April 2002 were studied. Patients able to fully re-expand their lungs were treated with VATS/TP; those who could not had PDC placement. Twenty-four (59%) were women. The mean age was 64 ± 13 years. VATS/TP was performed in only seven patients (17%), and 34 patients had PDC placement. The length of stay (LOS) was 2.8 ± 5.1 days in the 18 PDC patients who were initially seen as outpatients and 9.4 ± 9.0 days in the inpatient population (P = 0.013). Short (< 2 days) LOS occurred in 19 (56%) PDC patients but in no VATS/TP patients (P = 0.007). Twenty-eight patients (68%) died during follow-up: three VATS/TP patients (43%) and 25 (74%) PDC patients (P = 0.112). We conclude that the PDC system is an efficacious treatment of patients with MPEs and trapped lungs. The LOS is short in patients initially evaluated as outpatients which contributes to the perception of increased quality of life.


Related Articles

  • Single center experience on talc poudrage morbidity: focus on high talc dosage. Leuzzi, Giovanni; Vita, Maria Letizia; Porziella, Venanzio; Congedo, Maria Teresa; Cesario, Alfredo // Journal of Cardiothoracic Surgery;2011, Vol. 6 Issue 1, p87 

    Malignant pleural effusion (MPE) is a common clinical problem of concern for most of the pneumologists and thoracic surgeons. A general consensus regarding the use of talc poudrage in treatment of MPE exists, but only few studies analyzed in detail talc insufflation related pulmonary morbidity....

  • Indwelling Tunneled Pleural Catheters for the Management of Hepatic Hydrothorax: A Word of Caution. Mirrakhimov, Aibek E.; Ayach, Taha; Gray, Adam; Chen, Alexander C.; Crippin, Jeffrey S. // Annals of the American Thoracic Society;Aug2016, Vol. 13 Issue 8, p1432 

    No abstract available.

  • LTA-T for malignant pleural effusions. Wall, J. // Thorax;Mar2009, Vol. 64 Issue 3, p269 

    The article focuses on the study which examined the potential of lipoteichoic acid T (LTA-T) for patients with malignant pleural effusions. There were 14 patients with malignant pleural effusions who participated in the phase I toxicity and dose escalation study. In this study, researchers used...

  • Thoracoscopic palliative treatment of malignant pleural effusions: results in 273 patients. Arapis, K.; Caliandro, R.; Stern, J-B.; Girard, P.; Debrosse, D.; Gossot, D. // Surgical Endoscopy;Jun2006, Vol. 20 Issue 6, p919 

    Background: The aim of this study was to analyze the results of pleurodesis for malignant pleural effusion performed by surgeons.Patients and Methods: A series of 273 patients with malignant pleural effusion underwent thoracoscopy with the aim of performing a palliative...

  • Variation in use of video assisted thoracic surgery in the United Kingdom. Sedrakyan, Artyom; Van der Meulen, Jan; Lewsey, James; Treasure, Tom // BMJ: British Medical Journal (International Edition);10/30/2004, Vol. 329 Issue 7473, p1011 

    Focuses on video assisted thoracic surgery, a minimally invasive technique for the diagnosis and treatment of lung and pleural disease. Description of this technique; Determination of variation in the use of this procedure in medical practice in the United Kingdom; Assertion that this technique...

  • Management of Chylothorax in Children. Suddaby, Elizabeth C.; Schiller, Sue // Pediatric Nursing;Jul/Aug2004, Vol. 30 Issue 4, p290 

    Chylothorax is a collection of a white milky drainage from the lym-phatic system within the thoracic cavity that can impair respiratory status as it accumulates. Management of this uncommon complication of thoracic surgery can include: total parenteral nutrition (TPN), low-fat enteral nutrition,...

  • Advances in Thoracoscopy: 100 Years since Jacobaeus. Lee, Pyng; Mathur, Praveen N.; Colt, Henri G. // Respiration;2010, Vol. 79 Issue 3, p177 

    Thoracoscopy provides the physician a window into the pleural space, and enables the biopsy of the parietal pleura under direct visual guidance, chest tube placement and pleurodesis for recurrent pleural effusions or pneumothoraces in selected patients. In this review, we discuss the advances...

  • pleurorrhea.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p1807 

    A definition of the medical term "pleurorrhea," which refers to effusion of fluid into the pleura, is presented.

  • Pleural Effusion from Malignancy. Leff, Alan; Hopewell, Philip C.; Costello, John // Annals of Internal Medicine;Apr78, Vol. 88 Issue 4, p532 

    Provides information on pleural effusion from metastatic malignancy. Dynamics of pleural-fluid formation; Characteristics of malignant effusion; Diagnosis of metastatic pleural malignancy; Details on the methods of treatment of recurrent effusion; Conclusions and recommendations.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics