Abstract
The goal of this paper is to evaluate the literature published over past 3 years and emphasize the most recent updates in the diagnosis and management of malignant pleural effusions (MPE). The management of MPE is focused on palliation of symptoms and should take into account patient preferences and anticipated survival. Chemical pleurodesis and indwelling pleural catheters (IPC) are both definitive options for recurrent symptomatic MPE. IPC placement reduces hospitalization and can result in spontaneous pleurodesis, but these advantages must be weighed against the cost of materials and ongoing care. IPC is preferred over attempted pleurodesis in the presence of nonexpandable lung. The use of vacuum bottles during therapeutic thoracentesis is associated with increased pain and complications, and drainage via manual aspiration or to gravity is preferred. The routine use of manometry does not appear to reduce procedure-related discomfort. Several new advances have been made and discovered in relation to procedural aspects of thoracentesis, diagnosis, and management of MPE. We summarized the most relevant trials and studies and discuss their application in the clinical practice.
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