BACKGROUND: Malignant pleural effusion (MPE) complicates many neoplasms and its incidence is expected to rise in parallel with the aging population and longer survival of cancer patients. Although a clear consensus exists on indwelling catheters in patients with poor performance status, no study has hitherto compared different devices in patients requiring temporary or definitive drainage following talc poudrage. METHODS: This is a prospective, two-arm, pilot study on patients with MPE undergoing talc poudrage, comparing two different catheters (PleurX® versus Pleurocath®) positioned because of the inefficacy of the procedure or the high risk of short-term failure. End points of the study were quality of life (QoL), median dyspnea and chest pain assessment by EORTC questionnaires and a 100 mm visual analog scale, total in-hospital length of stay and frequency of serious adverse events. RESULTS: No difference was observed between the two groups in in mean dyspnea and mean chest pain in any questions of the EORTC QLQ-C30 and QLQ-LC13 questionnaires. Duration of the procedure was significantly longer in the PleurX® group versus the Pleurocath® group (72±33 versus 44±13 minutes; P=0.03). No difference was observed between the two groups in total length of hospital stay (P=1.00) or complication rate (P=1.00). CONCLUSIONS: For the cohort of patients still needing indwelling pleural catheters (PC) after thoracoscopic talc poudrage, PleurX® is suggested when drain removal is unlikely due to short life expectancy or the high chance of pleurodesis failure. Conversely, Pleurocath® should be recommended in all other patients as it is faster to place and easier to remove. KEYWORDS: Malignant pleural effusion (MPE); talc poudrage; indwelling pleural catheter (indwelling PC).
BACKGROUND: Malignant pleural effusion (MPE) complicates many neoplasms and its incidence is expected to rise in parallel with the aging population and longer survival of cancer patients. Although a clear consensus exists on indwelling catheters in patients with poor performance status, no study has hitherto compared different devices in patients requiring temporary or definitive drainage following talc poudrage. METHODS: This is a prospective, two-arm, pilot study on patients with MPE undergoing talc poudrage, comparing two different catheters (PleurX® versus Pleurocath®) positioned because of the inefficacy of the procedure or the high risk of short-term failure. End points of the study were quality of life (QoL), median dyspnea and chest pain assessment by EORTC questionnaires and a 100 mm visual analog scale, total in-hospital length of stay and frequency of serious adverse events. RESULTS: No difference was observed between the two groups in in mean dyspnea and mean chest pain in any questions of the EORTC QLQ-C30 and QLQ-LC13 questionnaires. Duration of the procedure was significantly longer in the PleurX® group versus the Pleurocath® group (72±33 versus 44±13 minutes; P=0.03). No difference was observed between the two groups in total length of hospital stay (P=1.00) or complication rate (P=1.00). CONCLUSIONS: For the cohort of patients still needing indwelling pleural catheters (PC) after thoracoscopic talc poudrage, PleurX® is suggested when drain removal is unlikely due to short life expectancy or the high chance of pleurodesis failure. Conversely, Pleurocath® should be recommended in all other patients as it is faster to place and easier to remove. KEYWORDS: Malignant pleural effusion (MPE); talc poudrage; indwelling pleural catheter (indwelling PC).
Authors: Rajesh Thomas; Edward T H Fysh; Nicola A Smith; Pyng Lee; Benjamin C H Kwan; Elaine Yap; Fiona C Horwood; Francesco Piccolo; David C L Lam; Luke A Garske; Ranjan Shrestha; Christopher Kosky; Catherine A Read; Kevin Murray; Y C Gary Lee Journal: JAMA Date: 2017-11-21 Impact factor: 56.272
Authors: Carolyn M Dresler; Jemi Olak; James E Herndon; William G Richards; Ernest Scalzetti; Stewart B Fleishman; Kemp H Kernstine; Todd Demmy; David M Jablons; Leslie Kohman; Thomas M Daniel; George B Haasler; David J Sugarbaker Journal: Chest Date: 2005-03 Impact factor: 9.410
Authors: Helen E Davies; Eleanor K Mishra; Brennan C Kahan; John M Wrightson; Andrew E Stanton; Anur Guhan; Christopher W H Davies; Jamal Grayez; Richard Harrison; Anjani Prasad; Nicola Crosthwaite; Y C Gary Lee; Robert J O Davies; Robert F Miller; Najib M Rahman Journal: JAMA Date: 2012-06-13 Impact factor: 56.272
Authors: Maree Azzopardi; José M Porcel; Coenraad F N Koegelenberg; Y C Gary Lee; Edward T H Fysh Journal: Semin Respir Crit Care Med Date: 2014-12-02 Impact factor: 3.119