Assessing the Outcomes and Complications of Small-Bore Wire-guided Chest Drains in Treatment of Pneumothorax, Malignant Effusions, and Pleural Empyema

Abstract

Background: Pleural effusion, empyema, and pneumothorax are clinical disorders associated with high mortality rates. Initially, treatment is medical; however, percutaneous drainage using small wire-guided chest drains is considered a suitable method for patients with pleural fluid accumulation, empyema, or pneumothorax. Objectives: This study aimed to investigate the effectiveness of small-bore wire-guided chest drains (SBWGD) in patients with empyema and pleural effusion. Methods: A total of 101 patients with pneumothorax, empyema, or malignant pleural effusion who underwent thoracocentesis for palliative or symptomatic treatment using an SBWGD were enrolled. Demographic and clinical data, as well as the duration of the drain’s stay, outcomes, and complications, were recorded in a checklist. Data were analyzed at a significance level of less than 0.05 using SPSS software version 24. Results: The mean age of the patients was 73.08 ± 15.63 years (range 21 - 99 years), and 58 patients (57.4%) were male. The most common indication for placing a pleural catheter was pleural effusion. The most prevalent underlying diseases were hypertension in 42 patients (42.6%), ischemic heart disease in 37 patients, and diabetes in 35 patients. Sixteen patients (15.8%) died during the follow-up period, and 5 patients (4.9%) experienced various complications, including catheter blockage (n = 2), pneumothorax (n = 2), and hemothorax (n = 1). The occurrence of complications was not significantly associated with gender (P = 0.902) or age (P = 0.630). Conclusions: Our findings showed that this method was associated with few complications, and these complications were not related to the gender or age of the patients. Although the mortality rate during the follow-up period was relatively high, most deaths occurred in elderly patients and those with multiple underlying diseases. The use of an SBWGD in cases of malignant effusion and pleural empyema is a safe and low-risk method, and it can be recommended for managing pleural effusion.