Vol 16, No 2 (2022)
Research paper
Published online: 2022-02-05

open access

Page views 4773
Article views/downloads 415
Get Citation

Connect on Social Media

Connect on Social Media

Use of tunnelled pleural catheter for palliative treatment of malignant pleural effusion: Experience of a third level hospital

Juan David Botero12, Javier Iván Lasso, María Natalia Serrano12, Claudio Villaquiran12, July Vianeth Torres3, María José Fernández12
Palliat Med Pract 2022;16(2):103-107.

Abstract

Introduction: Pleural effusion is a manifestation of advanced cancer that is associated with symptoms
whose control requires adopting different strategies. This study aimed to characterize the population of
patients with malignant pleural effusion who underwent placement (or insertion) of a tunnelled pleural
catheter to alleviate dyspnoea, describe the experience of its use and evaluate the 30-day hospitalization
rate for pleural effusion and the percentage of early and late complications.
Patients and methods: This study is a series of cases with cancer taken to implantation of a closed
pleural drainage system during the year 2020 in a third level hospital in Colombia.
Results: Eight patients underwent this procedure, in whom implantation was successful. Pleural effusion
due to breast cancer was the main indication. No late catheter complications were recorded given the high
30-day mortality, despite a low LENT (LDH, ECOG, neutrophilia and tumour type) score in some patients.
Conclusions: The indwelling tunnelled pleural catheter is useful in the palliative treatment of malignant
pleural effusion with few complications. It is necessary to evaluate the performance of the LENT scale in
the study population, given that despite a low score, the 30-day mortality rate was high.

Article available in PDF format

View PDF Download PDF file

References

  1. Asciak R, Rahman N. Malignant Pleural Effusion. Clin Chest Med. 2018; 39(1): 181–193.
  2. Psallidas I, Kalomenidis I, Porcel JM, et al. Malignant pleural effusion: from bench to bedside. Eur Respir Rev. 2016; 25(140): 189–198.
  3. McKenzie E, Hwang MK, Chan S, et al. Predictors of dyspnea in patients with advanced cancer. Ann Palliat Med. 2018; 7(4): 427–436.
  4. Cantey EP, Walter JM, Corbridge T, et al. Complications of thoracentesis: incidence, risk factors, and strategies for prevention. Curr Opin Pulm Med. 2016; 22(4): 378–385.
  5. Skok K, Hladnik G, Grm A, et al. Malignant Pleural Effusion and Its Current Management: A Review. Medicina. 2019; 55(8): 490.
  6. Koegelenberg CFN, Shaw JA, Irusen EM, et al. Contemporary best practice in the management of malignant pleural effusion. Ther Adv Respir Dis. 2018; 12: 1753466618785098.
  7. Thomas R, Fysh ETH, Smith NA, et al. Effect of an Indwelling Pleural Catheter vs Talc Pleurodesis on Hospitalization Days in Patients With Malignant Pleural Effusion: The AMPLE Randomized Clinical Trial. JAMA. 2017; 318(19): 1903–1912.
  8. Chalhoub M, Saqib A, Castellano M. Indwelling pleural catheters: complications and management strategies. J Thorac Dis. 2018; 10(7): 4659–4666.
  9. Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong, Wong W, Tam TC, Wong MK, Lui MM, Ip MS, et al. Managing malignant pleural effusion with an indwelling pleural catheter: factors associated with spontaneous pleurodesis. Hong Kong Med J [Internet]. 2016 . http://www.hkmj.org/abstracts/v22n4/334.htm (17 Oct 2021).
  10. Chalhoub M, Ali Z, Sasso L, et al. Experience with indwelling pleural catheters in the treatment of recurrent pleural effusions. Ther Adv Respir Dis. 2016; 10(6): 566–572.
  11. Botana-Rial M, Ramos-Hernández C, Lojo-Rodríguez I, et al. Cost Effectiveness of Malignant Pleural Effusion with Indwelling Catheter: Systematic Review. J Palliat Med. 2021; 24(8): 1206–1212.
  12. Abrão FC, Abreu IR, Cavalcanti MG, et al. Use of indwelling pleural catheters for the definitive treatment of malignant pleural effusion. J Bras Pneumol. 2017; 43(1): 14–17.
  13. Páez-Codeso F, Dorado-Galindo A, Jiménez-Fernández D, et al. Tratamiento paliativo ambulatorio de disnea con catéter pleural tunelizado en derrame pleural maligno. Estudio descriptivo. NCT Neumología y Cirugía de Tórax. 2017; 76(4): 308–314.
  14. Clive AO, Kahan BC, Hooper CE, et al. Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score. Thorax. 2014; 69(12): 1098–1104.
  15. Petrella F, Maisonneuve P, Borri A, et al. Pleural catheters after thoracoscopic treatment of malignant pleural effusion: a randomized comparative study on quality of life. J Thorac Dis. 2018; 10(5): 2999–3004.
  16. Sivakumar P, Douiri A, West A, et al. OPTIMUM: a protocol for a multicentre randomised controlled trial comparing Out Patient Talc slurry via Indwelling pleural catheter for Malignant pleural effusion vs Usual inpatient Management. BMJ Open. 2016; 6(10): e012795.
  17. Akram MJ, Khalid U, Bakar MA, et al. Indications and clinical outcomes of indwelling pleural catheter placement in patients with malignant pleural effusion in a cancer setting hospital. Clin Respir J. 2020; 14(11): 1040–1049.
  18. Messeder SJ, Thomson MC, Hu MK, et al. Indwelling pleural catheters: an overview and real-life experience. QJM. 2019; 112(8): 599–604.
  19. Frost N, Brünger M, Ruwwe-Glösenkamp C, et al. Indwelling pleural catheters for malignancy-associated pleural effusion: report on a single centre's ten years of experience. BMC Pulm Med. 2019; 19(1): 232.



Palliative Medicine in Practice