Patient evaluation for rapid pleurodesis of malignant pleural effusions

Rebecca Krochmal, Chakravarthy Reddy, Lonny Yarmus, Neeraj R. Desai, David Feller-Kopman, Hans J. Lee

Research output: Contribution to journalArticle

Abstract

Background: Malignant pleural effusions (MPEs) represent advanced stage disease with potentially significant patient discomfort due to dyspnea. Palliative management options include repetitive thoracenteses, placement of a tunneled pleural catheter (TPC), chemical pleurodesis, or some combination of these procedures. The rapid pleurodesis procedure combines thoracoscopic talc pleurodesis and insertion of a TPC at the same time with the goals of reducing both the length of hospitalization and the duration of catheter use. The rapid pleurodesis procedure has previously been described to achieve both of these goals in a pilot study of 30 patients with fully expandable lungs. Both symptoms of dyspnea and quality of life improved with few complications. Additional data on procedural effectiveness is needed to optimize patient selection for this procedure. Methods: We performed a retrospective analysis of patients who had undergone rapid pleurodesis protocol at two academic institutions over a 40-month period. Data was collected and analyzed on time to removal of the TPC, chemotherapy, malignancy type, complications, age, and catheter occlusion. Results: A total of 29 patients underwent the rapid pleurodesis protocol with a median hospital length of stay of 2 days. Total length of hospitalization was not significantly different between patients with and without primary lung cancer. Median duration of the indwelling TPC was 10 days. Patients with primary lung cancer and those actively or recently undergoing chemotherapy maintained the catheter longer than their counterparts. Conclusions: The rapid pleurodesis protocol should be considered a viable treatment option for select patients with symptomatic recurrent MPEs undergoing chemical pleurodesis.

Original languageEnglish (US)
Pages (from-to)2538-2543
Number of pages6
JournalJournal of Thoracic Disease
Volume8
Issue number9
DOIs
StatePublished - Jan 1 2016

Keywords

  • Malignant pleural effusion (MPE)
  • Pleurodesis
  • Tunneled pleural catheter (TPC)

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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