Lung Cancer |

Intrapleural Instillation of 50% Glucose via 10 F Catheter in Symptomatic Malignant Pleural Effusion in Lung Cancer FREE TO VIEW

Maan Hong Jung, MD; Chul Ho Oak, MD; Jae Hoon Kim, MD; Sung Jin Nam, MD; Tae Won Jang, MD
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Kosin University Gospel Hospital, Busan, Korea (the Republic of)

Chest. 2015;148(4_MeetingAbstracts):589A. doi:10.1378/chest.2279376
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SESSION TITLE: Lung Cancer Treatment Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Malignant pleural effusion develops frequently during the courses of lung cancer. Even though several agents, like talc, vibramycin, or chemotherapeutic agents, are used for pleurodesis, the efficacy is variable and side effects are troublesome. The instillation of 50% glucose has been reported to be a safe and useful as a sclerosing agent in pneumothorax. We retrospectively evaluated the efficacy of 50% glucose intrapleural instillation in malignant pleural effusion of lung cancer.

METHODS: Thirty five patients (22 men and 13 women, mean age 69.5 years) of lung cancer, who drainaed pleural effusion for the relief of dyspnea via 10 F catheter, were enrolled. Adenocarcinoma was in 20 cases, and 12 cases were central-typed tumor. The instillation of 100 ml of 50% glucose was done when the drainage was decreased to 100 ml a day and the expansion of lungs was found on the chest film. The instillation was repeated in 4 cases within 5 - 7 days. When the daily drainage decreased to 50 ml and the re-accumulation of effusion was not found on the chest film within 10 days, the catheter was removed and noted the pleurodesis was successful.

RESULTS: The median time from the diagnoses of lung cancer to the catheter insertion were 93 days. In 18 cases, the instillation was done within 7 days after catheter insertion. There were no specific initial complications except mild chest pain. In 27 patients, the catheter were removed in 10 days, and 22 cases were noted successful (success rate of 62.5%). The success rates were higher in women (69.2% vs. 59.2%, P=0.005), central-typed tumor (66.7% vs. 60.9%, P=0.02), and in cases when the instillation was done within 7 days (78% vs. 47%, P=0.007). In 3 cases, the catheter were removed prematurely because of malfunction of the catheter after instillation.

CONCLUSIONS: The instillation of 50% glucose into the pleural cavity as a scleoring agent was successful in 62.5% of lung cancer patients with malignant pleural effusion. This effect was higher in women, central typed tumor, and early instillation within 7 days.

CLINICAL IMPLICATIONS: The instillation of 100 - 200 ml of 50% glucose through 10 F catheter in cases of symptomatic malignant pleural effusion of lung cancer was effective and safe.

DISCLOSURE: The following authors have nothing to disclose: Maan Hong Jung, Chul Ho Oak, Jae Hoon Kim, Sung Jin Nam, Tae Won Jang

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