title: The efficacy of Jackson drain in the application to be a tunnel pleural catheter (TPC) in the management of malignant pleural effusion.
abstract: BACKGROUND
  Malignant pleural effusion (MPE) is a common clinical problem in patients with advanced cancer and portends a poor prognosis, which means survival of less than six months. In June 1997, the US-FDA approved an indwelling TPC with a one-way drainage valve to be used in the management of MPE. Although popularity of this TPC has increased over the past few years, the experience with this device remains limited in Thai patients. One of the reasons is its high cost.
  
  
  OBJECTIVE
  Assess the efficacy and the safety of customary indwelling TPC by using Jackson drain in the management of patients with symptomatic MPE.
  
  
  METHODS
  Ten patients with symptomatic MPE were receiving these catheters (18 Fr Silicone catheters with 25 cm fenestrated length) to drain effusion via plastic vacuum bottles (250 ml) every other day or as needed to relieve dyspnea. The patient's dyspnic respiration, quality of life, and comfort during the catheter's application were quantified with a Borg score, the St. George Respiratory Disease Questionnaire (SGRQ), and the comfort's score, respectively. These parameters were recorded at initial (before insertion) and 2-week follow-up visit. Pain after 24 hours of each insertion was quantified by visual pain analogue scale (VPAS). Patients were followed until either death or catheter removal.
  
  
  RESULTS
  The Borg score, SGRQ, and comfort's score showed significant improvement at 2-week visit (p < 0.05). Mean VPAS was 2.44. There was no early (2-week) complication, but the catheters were obstructed in three patients (mean = 60 days) and slipped out in two (day 18, day 50).
  
  
  CONCLUSIONS
  This modified Jackson drain was effective in the treatment of MPE as a TPC without early complications.
authors.affiliation: Division of Respiratory Disease and Tuberculosis, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. tscheikuna@gmail.com
authors.forename: Jamsak
authors.initials: J
authors.lastname: Tscheikuna
authors.forename: Preecha
authors.initials: P
authors.lastname: Thomrongpairoj
authors.forename: Suppareurg
authors.initials: S
authors.lastname: Disayabutr
mesh_terms: D000328:Adult; D000368:Aged; D002408:Catheters, Indwelling / Q000009:adverse effects; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods; D016066:Pleural Effusion, Malignant / Q000628:therapy*; D011788:Quality of Life; D016896:Treatment Outcome