Document Detail


Effectiveness and safety of outpatient pleurodesis in patients with recurrent malignant pleural effusion and low performance status.
MedLine Citation:
PMID:  21484035     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the effectiveness and safety of pleurodesis carried out entirely on an outpatient basis in patients with recurrent malignant pleural effusions and Karnofsky Performance Status scores <70.
METHODS: This study was a prospective trial comprising patients with symptomatic recurrent malignant pleural effusion and Karnofsky Performance Status scores <70 but >30. All selected patients underwent pleural catheter placement (14 Fr) in an outpatient facility. When chest radiography revealed post-drainage lung expansion of >90%, pleurodesis (3 g of talc) was performed. Catheters were maintained until the daily output was ,100 mL/day. The patients were evaluated in the first month and every three months thereafter for fluid recurrence, the need for additional procedures, and complications.
RESULTS: During the study period (January 2005 to July 2007), 64 patients (24 men, 40 women), with an average age of 61.4 years, underwent elective chest tube drainage. Primary sites of the underlying malignancy were breast (27), lung (22), and others (15). Sixty-six pleural catheters were placed (bilaterally in 2 patients), and 52 talc pleurodesis procedures were performed. Fourteen patients had a trapped lung and were excluded from the trial. No complications were observed during catheter placement or pleurodesis. Post-pleurodesis complications included catheter obstruction (4 patients) and empyema (1). The average drainage time was 9.9 days. The recurrence rate observed in patients that were alive 30 days after pleurodesis was 13.9% (5/36 patients). Six patients required additional procedures after the pleurodesis. The average survival time was 101 days.
CONCLUSION: In this study, talc pleurodesis was safely performed in an outpatient setting with good efficacy and a reasonable complication rate, thereby avoiding hospital admission.
Authors:
Ricardo Mingarini Terra; Lisete Ribeiro Teixeira; Benoit Jacques Bibas; Paulo Manuel Pego-Fernandes; Francisco Suso Vargas; Fabio Biscegli Jatene
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinics (São Paulo, Brazil)     Volume:  66     ISSN:  1980-5322     ISO Abbreviation:  Clinics (Sao Paulo)     Publication Date:  2011  
Date Detail:
Created Date:  2011-04-12     Completed Date:  2011-11-09     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  101244734     Medline TA:  Clinics (Sao Paulo)     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  211-6     Citation Subset:  IM    
Affiliation:
Thoracic Surgery Division, Hospital das Clínicas, Faculdade de Mecicina, Universidade de São Paulo, São Paulo, Brazil. rmterra@uol.com.br
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Ambulatory Care Facilities
Female
Follow-Up Studies
Humans
Karnofsky Performance Status*
Male
Middle Aged
Pleural Effusion, Malignant / therapy*
Pleurodesis / adverse effects*,  methods
Prospective Studies
Recurrence
Talc / administration & dosage
Treatment Outcome
Chemical
Reg. No./Substance:
14807-96-6/Talc
Comments/Corrections

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