Indwelling pleural catheters and medical thoracoscopy

This narrative review explores the complementary roles of indwelling pleural catheters (IPCs) and medical thoracoscopy (MT) in the evaluation and management of unexplained exudative pleural effusions, including malignant pleural effusion. IPCs offer a minimally invasive strategy for long-term outpatient management, which is particularly advantageous for patients with non-expandable lungs or limited functional status. Conversely, MT remains the gold standard for diagnostic accuracy and facilitates therapeutic procedures such as pleurodesis under direct visualisation. Recent evidence supports the integration of IPCs and MT as a hybrid approach, offering synergistic benefits including enhanced symptom control, reduced hospital admissions and improved patient-centred outcomes. This review synthesises current literature to provide a practical and evidence-based overview of these techniques and their evolving role in pleural disease management.