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Indwelling pleural catheters for persistent pleural effusions secondary to post lung resection for malignancies

Jean Reinoso1, Ghulam Aftab1, Karthik Vijayan1

  • 1Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Florida, Gainesville, FL, USA.

Journal of Thoracic Disease
|June 16, 2023
PubMed
Abstract

Insights

Indwelling pleural catheters (IPCs) effectively manage recurrent nonmalignant pleural effusions after lung cancer surgery. This safe treatment offers a high rate of spontaneous pleurodesis with manageable complications.

Area of Science:

  • Thoracic Surgery
  • Pulmonology
  • Oncology

Background:

  • Nonmalignant pleural effusions (NMPEs) are common after lung resection.
  • Limited data exists on indwelling pleural catheter (IPC) use for NMPEs post-lung resection.
  • Hepatic hydrothorax is a known NMPE treated with IPCs.

Purpose of the Study:

  • To evaluate the safety and efficacy of IPCs for recurrent symptomatic NMPEs in lung cancer patients post-surgery.
  • To assess the rate of pleurodesis and complication rates associated with IPC use in this population.

Main Methods:

  • Retrospective analysis of lung cancer patients undergoing lobectomy or segmentectomy from January 2019 to June 2022.
  • 12 patients with recurrent symptomatic pleural effusions requiring IPC placement were included.
  • Primary endpoints: improved symptomatology and successful pleurodesis.

Main Results:

  • Mean time to IPC placement was 78.4 days post-surgery.
  • All 12 patients achieved spontaneous pleurodesis (SP) without re-accumulation of fluid.
  • Two patients (16.7%) experienced manageable skin infections; no pleural infections occurred.

Conclusions:

  • IPCs are a safe and effective treatment for recurrent NMPEs following lung cancer surgery.
  • High rates of pleurodesis and acceptable complication profiles were observed.
  • IPC offers a viable alternative for managing post-surgical pleural effusions.
Keywords:
Pleural effusioncase seriesindwelling pleural catheter (IPC)nonmalignant pleural effusion (NMPE)pleurodesis

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