title: Tunneled Pleural Catheter for the Treatment of Malignant Pleural Effusion: A Systematic Review and Meta-analysis.
abstract: Tunneled pleural catheter (TPC) has been widely used to control malignant pleural effusion (MPE); however, it is still not clear whether it is more effective than chemical pleurodesis. We performed a systematic review with meta-analysis to evaluate success and complication rate of TPC as compared with chemical pleurodesis in the management of MPE. PubMed, EMBASE, Cochrane central register of controlled trials, and MEDLINE were searched for English-language studies of clinical controlled trials comparing TPC with chemical pleurodesis until May 2014. Overall success and complication rate were evaluated. Relative risks (RRs) were estimated using random-effects model, and statistical heterogeneity was assessed using I test. Three trials involving 307 patients with MPE were included. The success rate was comparable between TPC and chemical pleurodesis group when all studies included in the analysis (RR, 0.8; 95% confidence interval, 0.53-1.19; P = 0.27). TPC had slightly higher complication rate but was not statistically significant (RR, 2; 95% confidence interval, 0.91-4.4; P = 0.09). Current evidence suggests that TPC and chemical pleurodesis are both effective treatment for recurrent MPE with similar success and complication rate. Further randomized controlled trials are needed to compare TPC with other therapies in patients with MPE.
authors: 1Department of Internal Medicine, Section of Pulmonary Diseases, Critical Care and Environmental Medicine, Tulane University Health Sciences Center, New Orleans, LA; 2Department of Internal Medicine, Good Samaritan Hospital, Cincinnati, OH; and 3Department of Medicine, Interventional Pulmonology, Roswell Park Cancer Institute, Buffalo, NY.
authors: Fayez
authors: F
authors: Kheir
authors: Khaled
authors: K
authors: Shawwa
authors: Khalid
authors: K
authors: Alokla
authors: Mohamed
authors: M
authors: Omballi
authors: Abdul Hamid
authors: AH
authors: Alraiyes
mesh_terms: D002404:Catheterization / Q000379:methods*; D004322:Drainage / Q000379:methods*; D006801:Humans; D016066:Pleural Effusion, Malignant / Q000473:pathology / Q000628:therapy*; D018700:Pleurodesis / Q000379:methods; D016896:Treatment Outcome