title: Preliminary results of a new small-bore percutaneous pleural catheter used for treatment of malignant pleural effusions in ECOG PS 3-4 patients.
abstract: BACKGROUND
  In cancer patients with malignant pleural effusions(MPEs),the commonest procedure to treat them with palliative intention is talc pleurodesis (TP) which can be obtained with talc slurry (TS) using small-bore catheters(SBC)or with thoracoscopic poudrage. SBC use is therefore rapidly increasing. The aim of this paper is to present our preliminary TP results using a new percutaneous chest drainage system(UNICO®, Redax, Mirandola Modena, Italy).
  
  
  METHODS
  In the period 1st March-20th of July 2011,seven consecutive ECOG PS 3-4 patients(4 females, mean age 73.2 ± 12.1 years),unfit for thoracoscopic talc poudrage, were enrolled in our study. All patients received many thoracentesis before the placement of a chest drainage(median thoracentesis number:4.42 ± 1.13).UNICO® was bedside placed in all cases and TS was administered through the drainage when the overall fluid amount didn't exceed 150-200 ml/24 h and the lung was correctly re-expanded at the chest X-ray control.
  
  
  RESULTS
  There were no clinical complications following the placement of the drainage: its placement was easy, safe and well-tolerated by all patients. The median chest tube stay, before TS, was 7.2 ± 2.7 days while the median chest tube stay after TS was 1.5 ± 0.7 days. A satisfactory radiological lung expansion was achieved in all cases; PL effectiveness and dyspnea relief were complete in 6 and 4 cases, respectively. No patients required any further thoracentesis.
  
  
  CONCLUSIONS
  TS through UNICO® is safe and efficient. The drainage was well-tolerated by all patients, even in case of its long-term stay. We may conclude that bedside TS through this new small-bore percutaneous drainage should be proposed as a viable clinical solution for MPEs in ECOG PS 3-4 patients, unfit for a thoracoscopic procedure. Moreover, with this device, we believe that TS might be an accessible procedure for pulmonologists and oncologists too.
authors.affiliation: University of Torino, Department of Thoracic Surgery, San Giovanni Battista Hospital, Via Genova 3, Turin, Italy. pierluigi.filosso@unito.it
authors.forename: P L
authors.initials: PL
authors.lastname: Filosso
authors.forename: A
authors.initials: A
authors.lastname: Sandri
authors.forename: G
authors.initials: G
authors.lastname: Felletti
authors.forename: E
authors.initials: E
authors.lastname: Ruffini
authors.forename: P O
authors.initials: PO
authors.lastname: Lausi
authors.forename: A
authors.initials: A
authors.lastname: Oliaro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000150:complications; D002408:Catheters, Indwelling; D015505:Chest Tubes; D004322:Drainage / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000150:complications; D019152:Paracentesis / Q000295:instrumentation*; D016066:Pleural Effusion, Malignant / Q000209:etiology / Q000628:therapy*; D018700:Pleurodesis / Q000295:instrumentation*; D013274:Stomach Neoplasms / Q000150:complications