The long-term morbidity of pleuroperitoneal shunts in the management of recurrent malignant effusions

Genç, Onur

doi:10.1016/s1010-7940(00)00422-x

Cited by 108 publications

(63 citation statements)

References 9 publications

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“…In patients with a trapped lung due to extensive visceral pleural and lung parenchymal involvement, continuous evacuation of pleural fluid may be achieved by an indwelling pleural catheter or a pleuroperitoneal shunt, the latter requiring active participation of the patient by pumping fluid from the pleural to the peritoneal cavity due to the pressure difference between both cavities [25,26]. A pleuroperitoneal shunt entails a theoretical risk of tumour spread to the peritoneal cavity.…”

Section: Palliative Surgical Treatmentmentioning

confidence: 99%

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Multimodal management of malignant pleural mesothelioma: where are we today?

Schil

Opitz²,

Weder³

et al. 2014

Eur Respir J

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The prognosis of patients with malignant pleural mesothelioma remains poor and although it is clear that multimodal therapy is necessary to improve long-term results, precise treatment schemes have not yet been unequivocally established. Single-modality therapy does not have a major impact on long-term survival and combined-modality therapies are being further evaluated. However, the relative contributions of chemotherapy, radiotherapy and surgery have not been clearly determined at the present time. Moreover, the extent of resection and precise surgical procedure remain a highly debated topic. To better compare and combine results from different institutions and trials, uniform definitions of surgical procedures including extrapleural pneumonectomy and different forms of pleurectomy have recently been introduced. Due to the relatively higher morbidity and mortality of extrapleural pneumonectomy, there is currently a shift towards pleurectomy/decortication when a macroscopic complete resection of all tumour can be obtained by this procedure. In most recent trials, induction chemotherapy was administered to improve surgical resection rates but pathological complete responses are infrequently observed. The role of post-operative radiotherapy has to be further elucidated.Further treatment options that are currently explored include hyperthermic intrapleural chemotherapy, immunotherapy, gene therapy and photodynamic therapy. However, no randomised comparisons are available yet. @ERSpublications Treatment of malignant pleural mesothelioma remains controversial

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Section: Palliative Surgical Treatmentmentioning

confidence: 99%

“…However, this shunt is only inserted in patients who have a poor prognosis anyway; so, in daily clinical practice, this does not constitute a common problem. In a series of 160 patients, malignant seeding along the chest wall occurred in only one patient at the site of shunt insertion [25].…”

Section: Palliative Surgical Treatmentmentioning

confidence: 99%

Multimodal management of malignant pleural mesothelioma: where are we today?

Schil

Opitz²,

Weder³

et al. 2014

Eur Respir J

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“…The major concern with the use of this shunt in patients with lung cancer is a potential risk for iatrogenic dissemination of malignant cells to the peritoneal cavity, since there is no filter to prevent cancer cells entering the pump chamber. Given the concern of dissemination, 8,9) we performed repeated cytological examinations to con- firm the absence of lung cancer cells in the pleural fluid. Our experience with this case led us to conclude that a pleuroperitoneal shunt can improve the quality of life of patients with lung cancer, accompanied by persistent chylothorax that is refractory to surgery or chest tube drainage.…”

Section: Discussionmentioning

confidence: 99%

Pleuroperitoneal Shunt for Chylothorax and Chylopericardium in Lung Cancer: A Case Report

Shimmyo

Morita

Mineshita

et al. 2011

ATCS

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A 70-year-old man with T1N3M1 stage IV squamous cell carcinoma in the right upper lobe of the lung developed chylothorax and chylopericardium as rare simultaneous complications. Intravenous hyperalimentation, repeated pleurodesis, and ligation of the thoracic duct were all ineffective. A pleuroperitoneal shunt was inserted into the right pleural cavity from the fifth intercostal space, and a peritoneal catheter was placed in the abdominal cavity. Chylothorax was markedly improved, and the quality of life of the patient increased. This case indicates that a pleuroperitoneal shunt can be used for lung cancer-related chylothorax, as well as for malignant pleural effusion.

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“…Likewise, the application of pleuroperitoneal shunts is really of historic interest with the advent of the PleurX catheter [19].…”

Section: Malignant Pleural Effusionsmentioning

confidence: 99%

The Role of Thoracic Surgery in Palliative Care: A Review

Klapper¹,

Tong

2012

J Palliative Care Med

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The goal of palliative surgery, like that of palliative care in general, is to relieve symptoms and suffering due to a disease state, rather than curing the disease itself. Perhaps more so than other palliative interventions, patients and providers considering palliative surgery must carefully weigh the risks of the intervention with the intended benefit. The purpose of this article is to describe the variety of palliative operations performed by Thoracic surgeons as well as the indications and outcomes for these procedures.

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The long-term morbidity of pleuroperitoneal shunts in the management of recurrent malignant effusions

Cited by 108 publications

References 9 publications

Multimodal management of malignant pleural mesothelioma: where are we today?

Multimodal management of malignant pleural mesothelioma: where are we today?

Pleuroperitoneal Shunt for Chylothorax and Chylopericardium in Lung Cancer: A Case Report

The Role of Thoracic Surgery in Palliative Care: A Review

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