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Pleuroperitoneal shunting for malignant pleural effusions.

A G Little, M K Ferguson, H M Golomb

    Cancer
    |December 15, 1986
    PubMed
    Summary

    Pleuroperitoneal shunting offers a new, effective treatment for malignant pleural effusions, reducing symptoms with low morbidity. This method provides symptom relief and avoids lengthy hospital stays for eligible patients.

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    Area of Science:

    • Thoracic Surgery
    • Oncology
    • Medical Devices

    Background:

    • Malignant pleural effusions are often treated with thoracentesis or tube drainage, which can lead to prolonged hospitalization, pain, and treatment failure.
    • Traditional pleurodesis methods have significant drawbacks, including discomfort and a notable failure rate.

    Purpose of the Study:

    • To evaluate the efficacy and safety of a novel pleuroperitoneal shunting device for managing malignant pleural effusions.
    • To assess the potential of shunting as an alternative treatment for patients with refractory or complicated malignant pleural effusions.

    Main Methods:

    • A subcutaneous valved pump with pleural and peritoneal catheters was surgically placed in 17 patients with malignant pleural effusions.
    • Fluid was manually transferred from the pleural cavity to the peritoneal cavity against the pressure gradient.

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  • Patients with prior failed treatments (thoracentesis, chest tube with sclerosis) were included.

    • Main Results:

    • Shunting was performed without complication under local or general anesthesia.
    • Twelve out of 17 patients experienced significant palliation of respiratory symptoms, with diminished or stabilized effusions.
    • Five patients had minimal benefit due to poor health or inability to operate the pump; no peritoneal malignant cell dissemination was detected.

    Conclusions:

    • Pleuroperitoneal shunting is a viable new treatment for malignant pleural effusions, effectively palliating symptoms with low morbidity.
    • Advantages include minimal external tubing, potential for short hospitalization or outpatient management, and suitability for patients with trapped lungs or failed sclerosis.