Small bore catheter drainage and sclerotherapy for malignant pleural effusions

Abstract

The accumulation of large amounts of fluid in the pleural space is a common sequela of disseminated carcinomatosis. Traditional management has included therapeutic thoracentesis or the placement of a large bore chest tube for drainage with the subsequent installation of a sclerosing agent in an attempt to achieve pleural symphysis. An evaluation of all patients treated in this manner during a 4-year period was undertaken to assess the degree of success obtained with a large bore standard chest tube versus a small pigtail catheter. A study group consisting of 20 patients with a total of 24 pleural effusions was treated with drainage and sclerotherapy. In this group, eight of 13 effusions were adequately treated with pigtail catheter drainage and sclerotherapy, compared with four of 11 effusions adequately treated with standard chest tube drainage and sclerotherapy. Although the numbers are small, it appears that pigtail catheter drainage and sclerosis is at least as successful as the more traditional drainage with the standard chest tube.

Management of malignant pleural effusions

“…Most commonly, pleurodesis is performed via a standard tube thoracostomy. However, some studies have reported similar success rates with small-bore (3-5 mm) catheters [120][121][122][123][124][125]. Ideally, the chest tube is directed posteriorly toward the diaphragm.…”

Management of Malignant Pleural Effusions

“…Studies using small bore catheters (8-14 F) have reported similar success rates to those using large bore tubes, and small bore catheters are better tolerated and associated with less discomfort. [9][10][11][12] In the only controlled randomised study published to date, no significant diVerence was seen in the pleurodesis success rate but larger randomised studies are required to confirm these results. 13 A further potential advantage of the small bore catheter is in the area of ambulatory treatment of malignant eVusions.…”

“…The accurate detection of mediastinal lymph nodes in oesophageal cancer had obvious implications for patients with lung cancer, and the role of EUS in lung cancer was first described in Japan in 1988. 8 Further work confirmed the superior accuracy of EUS in the nodal staging of lung cancer compared with computed tomographic (CT) scanning, 9 although EUS is not yet used routinely in the preoperative staging of lung cancer in the UK.…”

A comparison of chemical pleurodesis using 8 f percutaneous catheter and 28 f chest tube thoracostomy in malignant pleural effusions

“…MPE constitutes approximately 30% -60% of all pleural fluids. [1][2][3] Symptomatic treatment in MPE is possible with pleurodesis and there are various catheter and drainage systems which are used for the purpose of drainage and pleurodesis.…”