Management of Malignant Pleural Effusion Associated with Trapped Lung Syndrome

Management of recurrent malignant pleural effusion associated with trapped lung syndrome remains problematic. An alternative treatment using a pleural catheter has been advocated. Between August 1999 and August 2002, 127 patients underwent thoracoscopy for malignant pleural effusion. Of these, 52 (4...

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Bibliographic Details
Published in:Asian cardiovascular & thoracic annals 2008-04, Vol.16 (2), p.120-123
Main Authors: Qureshi, Rizwan A, Collinson, Sandra L, Powell, Roy J, Froeschle, Peter O, Berrisford, Richard G
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Breast Neoplasms - complications
Breast Neoplasms - therapy
Catheters, Indwelling
Drainage - adverse effects
Drainage - instrumentation
Dyspnea - etiology
Dyspnea - therapy
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Length of Stay
Lung Diseases - complications
Lung Diseases - etiology
Lung Diseases - mortality
Lung Diseases - pathology
Lung Diseases - therapy
Male
Mesothelioma - complications
Mesothelioma - therapy
Middle Aged
Palliative Care
Patient Compliance
Patient Selection
Pleural Effusion, Malignant - complications
Pleural Effusion, Malignant - etiology
Pleural Effusion, Malignant - mortality
Pleural Effusion, Malignant - pathology
Pleural Effusion, Malignant - therapy
Pleurodesis
Quality of Life
Recurrence
Syndrome
Thoracic Surgery, Video-Assisted
Time Factors
Treatment Outcome
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Summary:Management of recurrent malignant pleural effusion associated with trapped lung syndrome remains problematic. An alternative treatment using a pleural catheter has been advocated. Between August 1999 and August 2002, 127 patients underwent thoracoscopy for malignant pleural effusion. Of these, 52 (41%) with trapped lung were managed by insertion of a pleural catheter. Mean age was 66 years (range, 42–89 years). The most frequent diagnosis was breast cancer. Spontaneous pleurodesis (drainage < 10 mL) occurred in 25 (48%) patients whose catheter was removed after 30 to 255 days (mean, 93.8 days). Symptomatic relief was achieved in 49 (94%) patients. Mean dyspnea score improved significantly from 3.0 to 1.9. Complications comprised catheter blockage, surgical emphysema, cellulitis, and loculated effusion in 2 patients each. Mean length of hospital stay was 3 days (range, 1–16 days). Median survival was 126 days (range, 10–175 days). We conclude that long-term placement of a pleural catheter provides effective palliation for malignant pleural effusion associated with trapped lung syndrome.
ISSN:0218-4923
1816-5370
DOI:10.1177/021849230801600208