Talc Pleurodesis Through Indwelling Pleural Catheters for Malignant Pleural Effusions Retrospective Case Series of a Novel Clinical Pathway

被引:37
作者
Ahmed, Liju [1 ]
Ip, Hugh [1 ]
Rao, Deepak [1 ]
Patel, Nishil [2 ]
Noorzad, Farinaz [1 ]
机构
[1] Guys & St Thomas NHS Trust, London, England
[2] Kings Coll London, London, England
关键词
DISEASE GUIDELINE 2010; SMALL-BORE; MANAGEMENT; OPTIONS; SLURRY;
D O I
10.1378/chest.14-0394
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Malignant pleural effusions cause significant morbidity, but there is no gold standard minimally invasive treatment. A new therapeutic approach combines talc pleurodesis and indwelling pleural catheters (IPCs) to enable outpatient management. This case series summarizes the safety and efficacy data of all patients (24) with a symptomatic malignant pleural effusion who underwent talc pleurodeses via IPCs between December 2010 and July 2013. Successful pleurodesis was achieved in 22 procedures (92%). There was one empyema, one hydropneumothorax, one recurrent effusion, and two minor complications: one drain site wound infection and one complaint of chest pain. Twenty-two procedures (92%) were performed in the outpatient setting. This report confirms the safety and efficacy of administering talc slurry through IPCs in an outpatient setting. Studies in a larger cohort are necessary to define the role of this novel approach in the treatment algorithm of patients with this condition.
引用
收藏
页码:E190 / E194
页数:5
相关论文
共 15 条
[1]   Effect of an Indwelling Pleural Catheter vs Chest Tube and Talc Pleurodesis for Relieving Dyspnea in Patients With Malignant Pleural Effusion The TIME2 Randomized Controlled Trial [J].
Davies, Helen E. ;
Mishra, Eleanor K. ;
Kahan, Brennan C. ;
Wrightson, John M. ;
Stanton, Andrew E. ;
Guhan, Anur ;
Davies, Christopher W. H. ;
Grayez, Jamal ;
Harrison, Richard ;
Prasad, Anjani ;
Crosthwaite, Nicola ;
Lee, Y. C. Gary ;
Davies, Robert J. O. ;
Miller, Robert F. ;
Rahman, Najib M. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2012, 307 (22) :2383-2389
[2]   Phase III intergroup study of talc poudrage vs talc slurry sclerosis for malignant pleural effusion [J].
Dresler, CM ;
Olak, J ;
Herndon, JE ;
Richards, WG ;
Scalzetti, E ;
Fleishman, SB ;
Kernstine, KH ;
Demmy, T ;
Jablons, DM ;
Kohman, L ;
Daniel, TM ;
Haasler, GB ;
Sugarbaker, DJ .
CHEST, 2005, 127 (03) :909-915
[3]   Malignant pleural effusions - Management options with consideration of coding, billing, and a decision approach [J].
Haas, Andrew R. ;
Sterman, Daniel H. ;
Musani, Ali I. .
CHEST, 2007, 132 (03) :1036-1041
[4]   Treatment Options for Malignant Pleural Effusions Patient Preference Does Matter [J].
Maskell, Nick A. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2012, 307 (22) :2432-2433
[5]   Outpatient management of malignant pleural effusions with small-bore, tunneled pleural catheters [J].
Musani, AI ;
Haas, AR ;
Seijo, L ;
Wilby, M ;
Sterman, DH .
RESPIRATION, 2004, 71 (06) :559-566
[6]   Ambulatory sclerotherapy for malignant pleural effusions [J].
Patz, EF ;
McAdams, HP ;
Goodman, PC ;
Blackwell, S ;
Crawford, J .
RADIOLOGY, 1996, 199 (01) :133-135
[7]   Local anaesthetic thoracoscopy: British Thoracic Society pleural disease guideline 2010 [J].
Rahman, Najib M. ;
Ali, Nabeel J. ;
Brown, Gail ;
Chapman, Stephen J. ;
Davies, Robert J. O. ;
Downer, Nicola J. ;
Gleeson, Fergus V. ;
Howes, Timothy Q. ;
Treasure, Tom ;
Singh, Shivani ;
Phillips, Gerrard D. .
THORAX, 2010, 65 :54-60
[8]   Management of a malignant pleural effusion: British Thoracic Society pleural disease guideline 2010 [J].
Roberts, Mark E. ;
Neville, Edmund ;
Berrisford, Richard G. ;
Antunes, George ;
Ali, Nabeel J. .
THORAX, 2010, 65 :32-40
[9]   Outpatient pleurodesis of malignant pleural effusions using a small-bore pigtail catheter [J].
Saffran, L ;
Ost, DE ;
Fein, AM ;
Schiff, MJ .
CHEST, 2000, 118 (02) :417-421
[10]  
Shaw P, 2004, COCHRANE DB SYST REV, DOI DOI 10.1002/14651858.CD002916.PUB2