Alain Tremblay1, Gaëtane Michaud. 1. Division of Respiratory Medicine, University of Calgary, Health Sciences Center, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1 Canada. alain.tremblay@ucalgary.ca
Abstract
INTRODUCTION: Malignant pleural effusions (MPEs) are a common cause of dyspnea in patients with advanced cancer. Tunnelled pleural catheters (TPCs) can be used in patients with this condition, but the published experience with them is limited. OBJECTIVE: To describe the use of TPCs in the management of MPE in a large group of patients in a clinical setting. METHODS: Retrospective analysis of 250 sequential TPC insertions in patients with MPEs in a single center. RESULTS: Two hundred fifty TPC procedures for MPE were performed in 223 patients (19 contralateral procedures and 8 repeat ipsilateral procedures) during a 3-year period. Symptom control was complete following 97 procedures (38.8%), was partial in 125 procedures (50%), and was absent in 9 procedures (3.6%); in addition, there were 10 failed TPC insertions (4.0%) and 9 TPC insertions (3.6%) without assessment of symptoms at the 2-week follow-up visit. Spontaneous pleurodesis occurred following 103 of the 240 successful TPC procedures (42.9%) and was more frequent when < or = 20% of the hemithorax contained fluid at the 2-week follow-up visit (57.2% vs 25.3%, respectively; p < 0.001). Catheters stayed in place for a median duration of 56 days. Following successful TPC placement, no further ipsilateral pleural procedures were required in 90.1% of cases. The overall median survival time following TPC insertion was 144 days. Complication rates were low and compared favorably with those seen with other treatment options. CONCLUSIONS: TPC placement is an effective method of palliation for MPE that allows outpatient management and low complication rates. The insertion of a TPC should be considered as a first-line treatment option in the management of patients with MPE.
INTRODUCTION:Malignant pleural effusions (MPEs) are a common cause of dyspnea in patients with advanced cancer. Tunnelled pleural catheters (TPCs) can be used in patients with this condition, but the published experience with them is limited. OBJECTIVE: To describe the use of TPCs in the management of MPE in a large group of patients in a clinical setting. METHODS: Retrospective analysis of 250 sequential TPC insertions in patients with MPEs in a single center. RESULTS: Two hundred fifty TPC procedures for MPE were performed in 223 patients (19 contralateral procedures and 8 repeat ipsilateral procedures) during a 3-year period. Symptom control was complete following 97 procedures (38.8%), was partial in 125 procedures (50%), and was absent in 9 procedures (3.6%); in addition, there were 10 failed TPC insertions (4.0%) and 9 TPC insertions (3.6%) without assessment of symptoms at the 2-week follow-up visit. Spontaneous pleurodesis occurred following 103 of the 240 successful TPC procedures (42.9%) and was more frequent when < or = 20% of the hemithorax contained fluid at the 2-week follow-up visit (57.2% vs 25.3%, respectively; p < 0.001). Catheters stayed in place for a median duration of 56 days. Following successful TPC placement, no further ipsilateral pleural procedures were required in 90.1% of cases. The overall median survival time following TPC insertion was 144 days. Complication rates were low and compared favorably with those seen with other treatment options. CONCLUSIONS:TPC placement is an effective method of palliation for MPE that allows outpatient management and low complication rates. The insertion of a TPC should be considered as a first-line treatment option in the management of patients with MPE.
Authors: Jeremy R Hogg; Michael Caccavale; Benjamin Gillen; Gavin McKenzie; Jay Vlaminck; Chad J Fleming; Andrew Stockland; Jeremy L Friese Journal: Semin Intervent Radiol Date: 2011-03 Impact factor: 1.513
Authors: Erin M DeBiasi; Margaret A Pisani; Terrence E Murphy; Katy Araujo; Anna Kookoolis; A Christine Argento; Jonathan Puchalski Journal: Eur Respir J Date: 2015-04-02 Impact factor: 16.671