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 (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.
Qureshi
Rizwan A
RA
Department of Thoracic Surgery,Exeter NHS Research and Development Support Unit Royal Devon & Exeter NHS Foundation Trust Exeter, United Kingdom. rizwanqureshi2@aol.com
Collinson
Sandra L
SL
Powell
Roy J
RJ
Froeschle
Peter O
PO
Berrisford
Richard G
RG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000150:complications / Q000628:therapy; D002408:Catheters, Indwelling; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation*; D004417:Dyspnea / Q000209:etiology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008171:Lung Diseases / Q000150:complications / Q000209:etiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008654:Mesothelioma / Q000150:complications / Q000628:therapy; D008875:Middle Aged; D010166:Palliative Care; D010349:Patient Compliance; D018579:Patient Selection; D016066:Pleural Effusion, Malignant / Q000150:complications / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018700:Pleurodesis; D011788:Quality of Life; D012008:Recurrence; D013577:Syndrome; D020775:Thoracic Surgery, Video-Assisted; D013997:Time Factors; D016896:Treatment Outcome