Tunneled pleural catheters for management of malignant pleural effusions: a 2-year review of outcomes at a high-volume center

Abstract

Background: Report outcomes of patients receiving tunneled pleural catheters (TPCs) for malignant pleural effusions (MPE) over a 2-year period. Methods: TPCs were placed by one interventional pulmonologist under moderate sedation using PleurX TM catheters between September 2014 and August 2016. Retrospective data was collected from electronic medical records of adult patients, with malignant etiology, MPE evidence, with no previous talc pleurodesis. Two study groups were defined as reaching autopleurodesis indicated by TPC removal date or failure to reach autopleurodesis indicated by death prior to TPC removal. Results: Total sample size was 83, where 33 were male and 50 were female. The mean age was 63.1 years. The most common type of cancer was lung (n=36, 43.4%). By September 2016, 60.2% (n=50) patients were deceased, and 8 of 83 patients were alive with continued TPC drainage. In total, 94 TPCs placed in 83 patients, which included five patients with bilateral placements. Only 75 patients were included in the final calculations, where 41 (54.7%) reached autopleurodesis, and 34 (45.3%) expired with TPC in place. It took a median of 50.0 days to reach autopleurodesis and a median of 52.5 days to expire with TPC. Conclusions: Our exploratory study reviewing the clinical outcomes and complications of TPCs in a high-volume institution represents a significant addition to the growing body of literature describing these catheters. Results show TPC use for the treatment of MPEs significantly aid in accomplishing autopleurodesis with minimal risk of complication.