gms | German Medical Science

21. Jahrestagung der Deutschen Gesellschaft für Thoraxchirurgie

Deutsche Gesellschaft für Thoraxchirurgie

27.09.-29.09.2012, Karlsruhe

Palliative management of patients with malignant pleural effusion: Permanent pleural catheter placement results in pleurodesis

Meeting Abstract

  • Jan Groetzner - Clemenshospital Münster, Thoraxchirurgie, Münster
  • Thomas Eickholt - Clemenshospital Münster, Thoraxchirurgie, Münster
  • Tim Kleffner - Clemenshospital Münster, Thoraxchirurgie, Münster
  • Carolin Dame - Clemenshospital Münster, Thoraxchirurgie, Münster
  • Claudio DallaRiva - Clemenshospital Münster, Thoraxchirurgie, Münster
  • Matthias Holzer - Clemenshospital Münster, Thoraxchirurgie, Münster
  • Peter Feindt - Clemenshospital Münster, Thoraxchirurgie, Münster

Deutsche Gesellschaft für Thoraxchirurgie. 21. Jahrestagung der Deutschen Gesellschaft für Thoraxchirurgie. Karlsruhe, 27.-29.09.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocHS 3.3

DOI: 10.3205/12dgt08, URN: urn:nbn:de:0183-12dgt088

Published: September 17, 2012

© 2012 Groetzner et al.
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Outline

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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 the treatment of 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.

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: Between 2009 and 2012, 55 patients underwent insertion of 62 PleurX-catheters for malignant pleural effusions.

Mean daily drainage volume was 130±112 ml overall.

Symptom relief was achieved in all patients (100%).

Duration of hospital stay after PleurX-insertion was 1.9±2.0 days.

Hospitalizations due to shortness of breath after insertion were rare (n=4) and associated to pleural effusions in 2 cases.

Fourteen patients died during PleurX-treatment due to progressive malignant disease with no association to PleurX-treatment. Adverse events were occlusion (n=6 (9.6%)) and pain (n=10 (16%)).

Overall, 68% of Pleurx-catheters were removed due to pleurodesis. Mean duration of PleurX-treatment was 85±64 d.

Conclusions: PleurX-treatment in end-stage patients with trapped lungs effectively relieves patients of dyspnea and hospitalization. Additionally, it results in pleurodesis in the majority of patients without any surgical procedure, anesthesia and prolonged in hospital stay.