Abstract
Background: Management of septated/loculated pleural effusion with failed tube drainage is limited to VATS or IPFT (Intra Pleural Fibrinolytic Therapy). VATS is an expensive modality with limited availability and an invasive procedure. IPFT is affordable, easily available therapy with good results and requires less skill as compared to VATS. Aim: To study the role of IPFT in Septated/Loculated pleural effusion with failed tube drainage. Methods: A 1-year case-control study done in India with 50 patients with failed tube drainage ( Results: Total number of STK doses were 6 in 84%(n= 21) and 4 in 16% (n=4). In our study, among cases and control mean pleural fluid drained after IPFT was 1298.00 ± 571.58 ml and 155.60±23.43 ml respectively. In cases and controls outcome was successful in 80% (n=20), 16% (n=4), partial response in 16%(n=4), 64% (n=16) and failure were 4% (n=1), 20% (n=5) respectively. ICD removal achieved at discharge in 60% (n=15) cases and 32% (n=8) among control group. 12% (n=3) of cases 28% (n=7) of controls were referred for VATS. Conclusions: IPFT is an effective, very safe and affordable option in septated/loculated pleural effusion with failed tube drainage, where VATS is not readily accessible. A multi-centric study should be done to make guidelines for IPFT use.
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