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Original Research: INTERVENTIONAL PULMONOLOGY |

Single-Center Experience With 250 Tunnelled Pleural Catheter Insertions for Malignant Pleural Effusion*

Alain Tremblay, MD, FCCP; Gaëtane Michaud, MD, FCCP
Author and Funding Information

*From the Divisions of Respiratory Medicine, University of Calgary; Southern Alberta Cancer Research Institute, Calgary, AB, Canada.

Correspondence to: Alain Tremblay, MD, FCCP, Division of Respiratory Medicine, Health Sciences Center, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1 Canada; e-mail: alain.tremblay@ucalgary.ca



Chest. 2006;129(2):362-368. doi:10.1378/chest.129.2.362
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Introduction: Malignant pleural effusions (MPEs) are a common cause of dyspnea in patients with advanced cancer. Tunnelled pleural catheters (TPCs) can be used in patients with this condition, but the published experience with them is limited.

Objective: To describe the use of TPCs in the management of MPE in a large group of patients in a clinical setting.

Methods: Retrospective analysis of 250 sequential TPC insertions in patients with MPEs in a single center.

Results: Two hundred fifty TPC procedures for MPE were performed in 223 patients (19 contralateral procedures and 8 repeat ipsilateral procedures) during a 3-year period. Symptom control was complete following 97 procedures (38.8%), was partial in 125 procedures (50%), and was absent in 9 procedures (3.6%); in addition, there were 10 failed TPC insertions (4.0%) and 9 TPC insertions (3.6%) without assessment of symptoms at the 2-week follow-up visit. Spontaneous pleurodesis occurred following 103 of the 240 successful TPC procedures (42.9%) and was more frequent when ≤ 20% of the hemithorax contained fluid at the 2-week follow-up visit (57.2% vs 25.3%, respectively; p < 0.001). Catheters stayed in place for a median duration of 56 days. Following successful TPC placement, no further ipsilateral pleural procedures were required in 90.1% of cases. The overall median survival time following TPC insertion was 144 days. Complication rates were low and compared favorably with those seen with other treatment options.

Conclusions: TPC placement is an effective method of palliation for MPE that allows outpatient management and low complication rates. The insertion of a TPC should be considered as a first-line treatment option in the management of patients with MPE.

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