PURPOSE: Recurrent pleural effusion is a common clinical problem. The safety, efficacy and cost-effectiveness of long term indwelling tunneled pleural catheter (Pleurx, Denver Biomaterials, Golden, CO) is well established in malignant pleural effusions. Howerver, the use of these catheters and their effectiveness in the management of benign pleural effusion has not evaluated.
METHODS: The charts of 248 patients with pleural effusion, who underwent placement of Pleurx catheter between August of 2000 and March of 2006, were reviewed. Forty-two patients with benign effusion were identified. Indications, outcomes, complications, and interventions were reviewed in this group of patients.
RESULTS: Of 42 patients with benign pleural effusion, there were 30 male and 12 female with a median age of 75 (+/− 15.3) years. The pleural effusion was unilateral in 39 patients and bilateral in 3. The effusion was secondary to open heart surgery n=11, congestive heart failure n=9, pleuritis n=6, renal failure n=4, liver failure n=3, and unknown n=9. Forty-five Pleurx catheters were placed. Of these, 38(84%) resulted in significant palliation without a major complication. Twenty-six catheters (58%) were removed when pleurodesis was achieved. Twelve (27%) catheters were either left in place until the patient died or are still functioning. Seven catheters (15%) were removed for complications. The mean duration of catheter usage was 95 days (range 1-429 days). The overall complication rate was 20% (9/45) and included 4 empyemas (9%), 3 catheter site infections (7%), and 2 bleedings (4%). Six (13%) interventions were required for catheter related complications or failures. No mortality was attributed to Pleurx catheter.
CONCLUSION: Pleurx catheter is an effective treatment for recurrent symptomatic benign pleural effusion. Prospective studies are required to compare the Pleurx catheter with conventional treatment modalities.
CLINICAL IMPLICATIONS: The Pleurx catheter system is a safe alternative in the management of benign pleural effusions. It provides long term palliation with good symptomatic response.
DISCLOSURE: Reza Khodaverdian, None.