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Ambulatory Thoracoscopic Pleurodesis Combined With Indwelling Pleural Catheter in Malignant Pleural Effusion.

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cam.issuedOnline2021-10-25
dc.contributor.authorFoo, Chuan T
dc.contributor.authorPulimood, Thomas
dc.contributor.authorKnolle, Martin
dc.contributor.authorMarciniak, Stefan J
dc.contributor.authorHerre, Jurgen
dc.contributor.orcidPulimood, Thomas Benjamin [0000-0001-8346-6663]
dc.contributor.orcidMarciniak, Stefan [0000-0001-8472-7183]
dc.date.accessioned2021-11-23T00:31:29Z
dc.date.available2021-11-23T00:31:29Z
dc.date.issued2021
dc.description.abstractBackground and Objective: Malignant pleural effusion (MPE) often results in debilitating symptoms. Relief of dyspnoea and improvement in quality of life can be achieved with either talc pleurodesis or insertion of an indwelling tunneled pleural catheter (IPC). The former requires a lengthy hospital stay and the latter is associated with lower pleurodesis rates. In response to limited hospital bed capacity, we developed a pragmatic approach in managing MPE by combining thoracoscopic talc poudrage and insertion of IPC into a single day case procedure. We present data on the safety and efficacy of this approach. Methods: Patients who had undergone the abovementioned procedure between 2017 and 2020 were analyzed. Demographic data, hospital length of stay (LOS), histological diagnosis, rates of pleurodesis success and procedural related complications were collated. Patients were followed-up for 6 months. Results: Forty-five patients underwent the procedure. Mean age was 68.5 ± 10.4 years and 56% were male. Histological diagnosis was achieved in all cases. 86.7% of patients were discharged on the day of the procedure. Median LOS was 0 (IQR 0-0) days. Successful pleurodesis was attained in 77.8% at 6-month follow-up. No procedure related deaths or IPC related infections were recorded. Conclusion: Ambulatory thoracoscopic poudrage and IPC insertion is a safe and effective option in the management of MPE. All patients received a definitive pleural intervention with 77.8% pleurodesis success at 6-months and majority of them discharged on the same day. Future randomized trials are required to confirm these findings.
dc.identifier.doi10.17863/CAM.78415
dc.identifier.eissn2296-875X
dc.identifier.issn2296-875X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/330971
dc.languageeng
dc.language.isoeng
dc.publisherFrontiers Media
dc.publisher.urlhttp://dx.doi.org/10.3389/fsurg.2021.738719
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectmalignant
dc.subjectneoplasia
dc.subjectoutpatient
dc.subjectpleural effusion
dc.subjectpleurodesis
dc.subjectthoracoscope
dc.titleAmbulatory Thoracoscopic Pleurodesis Combined With Indwelling Pleural Catheter in Malignant Pleural Effusion.
dc.typeArticle
dcterms.dateAccepted2021-10-05
prism.endingPage738719
prism.publicationNameFrontiers in Surgery
prism.startingPage738719
prism.volume8
pubs.funder-project-idMedical Research Council (G1002610)
pubs.funder-project-idMedical Research Council (MR/R009120/1)
pubs.funder-project-idMRC (MR/V028669/1)
pubs.funder-project-idEngineering and Physical Sciences Research Council (EP/S009000/1)
rioxxterms.licenseref.startdate2021-10-05
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionVoR
rioxxterms.versionofrecord10.3389/fsurg.2021.738719

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