gms | German Medical Science

Introduction: Malignant pleural effusions have a significant impact on morbidity, mortality and quality of life in patients suffering from advanced cancer.

Pleurodesis is the aim in treating malignant pleural effusions. Recently, successful management of malignant pleural effusions including permanent drainage and long-term pleurodesis due to insertion of a permanent pleural catheter (PleurX®, Ewimed, Germany) was published.

We report our experience of PleurX-treatment in end-stage patients with recurrent pleural effusions and trapped lungs in whom operative pleurodesis was impossible.

Material and methods: In a prospective study PleurX-catheters were inserted and suction was administered daily over a 30-day-period when removability was assessed first. Thereafter, daily suction was continued and removability was assessed weekly.

PleurX-Catheters were removed if drainage fluid was <20 ml/d.

Results: Since 2009, 73 patients underwent insertion of 80 PleurX-catheters for malignant pleural effusions.

Mean daily drainage volume was 135±118 ml overall.

Symptom relief was achieved in the majority of patients (98%).

Duration of hospital stay was 2.1±2.0 days. Hospitalizations due to shortness of breath after insertion were rare (n=5) and associated to pleural effusions in 2 cases.

Twenty patients died during PleurX-treatment due to progressive malignant disease with no association to PleurX – treatment. Adverse events were occlusion (n=4 (5,4%)) and pain (n=10(14%)).

Overall, in 70% of patients pleurodesis was achieved and Pleurx-catheters were removed in 61% of patients. Mean duration of PleurX-treatment was 65±61d.

Conclusion: PleurX-treatment in palliative patients with trapped lungs effectively relieves patients of dyspnea and hospitalization. Additionally, pleurodesis was achieved in the majority of patients without any surgical procedure, anesthesia and prolonged in hospital stay.