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Supportive Care in Cancer

, Volume 26, Issue 8, pp 2499–2502 | Cite as

Conventional versus pigtail chest tube—are they similar for treatment of malignant pleural effusions?

  • Maria Aurora Mendes
  • Nuno China Pereira
  • Carla Ribeiro
  • Manuela Vanzeller
  • Teresa Shiang
  • Rita Gaio
  • Sérgio Campainha
Commentary

Abstract

Introduction

The optimal chest tube type and size for drainage and chemical pleurodesis of malignant pleural effusions remains controversial. This retrospective study was conducted to compare the efficacy of conventional versus pigtail chest tube in the treatment of malignant pleural effusions.

Methods

Patients submitted to chest tube drainage and slurry talc pleurodesis due to malignant pleural effusion in our pulmonology ward from 2012 to 2016 were eligible. According to the type of chest tube, they were divided into two groups: group I—conventional chest tube and group II—pigtail chest tube. Number of deaths, recurrence of malignant pleural effusion, and timelines associated with the procedures were reviewed and compared between groups.

Results

Out of the 61 included patients, 46 (75.4%) were included in group I and 15 (24.6%) in group II. Only one patient had pigtail chest tube obstruction, with posterior insertion of conventional chest tube. Death during hospital stay and up to 3 months, recurrence at 4 weeks, total duration of hospital stay, time from chest tube insertion to pleurodesis, and time from chest tube insertion to removal were not significantly different between the two groups (all p > 0.05).

Discussion

These findings suggest that pigtail chest tube can be an alternative on palliation, with no compromise in pleurodesis performance.

Keywords

Malignant pleural effusion Pleurodesis Conventional and pigtail chest tube 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

References

  1. 1.
    Roberts ME, Neville E, Berrisford RG, Antunes G, Ali NJ, on behalf of the BTS Pleural Disease Guideline Group (2010) Management of a malignant pleural effusion: British Thoracic Society pleural disease guideline 2010. Thorax 65(Suppl 2):ii32–ii40Google Scholar
  2. 2.
    Xia H, Wang XJ, Zhou Q, Shi HZ, Tong ZH (2014) Efficacy and safety of talc pleurodesis for malignant pleural effusion: a meta-analysis. PLoS One 9(1):e87060CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Thomas R, Francis R, Davies HE, Lee YCG (2014) Interventional therapies for malignant pleural effusions: the present and the future. Respirology 19(6):809–822CrossRefPubMedGoogle Scholar
  4. 4.
    Light RW (2011) Pleural controversy: optimal chest tube size for drainage. Respirology 16:244–248CrossRefPubMedGoogle Scholar
  5. 5.
    Parulekar W, Di Primio G, Matzinger F, Dennie C, Bociek G (2001) Use of small-bore vs large-bore chest tubes for treatment of malignant pleural effusions. Chest 120(1):19–25CrossRefPubMedGoogle Scholar
  6. 6.
    Clementsen P, Evald T, Grode G, Hansen M, Krag Jacobsen G, Faurschou P (1998) Treatment of malignant pleural effusion: pleurodesis using a small percutaneous catheter. A prospective randomized study. Respir Med 92(3):593–596CrossRefPubMedGoogle Scholar
  7. 7.
    Parker LA, Charnock GC, Delany DJ (1989) Small bore catheter drainage and sclerotherapy for malignant pleural effusions. Cancer 64(6):1281–1221CrossRefGoogle Scholar
  8. 8.
    Ghoneim AHA, Elkomy HA, Elshora AE, Mehrez M (2014) Usefulness of pigtail catheter in pleurodesis of malignant pleural effusion. Egypt J Chest Dis Tuberc 63:107–112CrossRefGoogle Scholar
  9. 9.
    Heffner JE, Klein JS (2008) Recent advances in the diagnosis and management of malignant pleural effusions. Mayo Clin Proc 83(2):235–250CrossRefPubMedGoogle Scholar
  10. 10.
    Davies HE, Mishra EK, Kahan BC, Wrightson JM, Stanton AE, Guhan A, Davies CWH, Grayez J, Harrison R, Prasad A, Crosthwaite N, Lee YCG, Davies RJO, Miller RF, Rahman NM (2012) Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: the TIME2 randomized controlled trial. JAMA 307(22):2383–2389CrossRefPubMedGoogle Scholar
  11. 11.
    Rahman NM, Pepperell J, Rehal S, Saba T, Tang A, Ali N, West A, Hettiarachchi G, Mukherjee D, Samuel J, Bentley A, Dowson L, Miles J, Ryan CF, Yoneda KY, Chauhan A, Corcoran JP, Psallidas I, Wrightson JM, Hallifax R, Davies HE, Lee YCG, Dobson M, Hedley EL, Seaton D, Russell N, Chapman M, McFadyen BM, Shaw RA, Davies RJO, Maskell NA, Nunn AJ, Miller RF (2015) Effect of opioids vs NSAIDs and larger vs smaller chest tube size on pain control and pleurodesis efficacy among patients with malignant pleural effusion: the TIME1 randomized clinical trial. JAMA 314(24):2641–2653CrossRefPubMedGoogle Scholar
  12. 12.
    Burgers JA, Kunst PWA, Koolen MGJ, Willems LNA, Burgers JS, van den Heuvel M (2008) Pleural drainage and pleurodesis: implementation of guidelines in four hospitals. Eur Respir J 32:1321–1327CrossRefPubMedGoogle Scholar
  13. 13.
    Caglayan B, Torun E, Turan D, Fidan A, Gemici C, Sarac G, Salepci B, Kiral N (2008) Efficacy of iodopovidone pleurodesis and comparison of small-bore catheter versus large-bore chest tube. Ann Surg Oncol 15(9):2594–2599CrossRefPubMedGoogle Scholar
  14. 14.
    Fysh ETH, Waterer GW, Kendall PA, Bremner PR, Dina S, Geelhoed E, McCarney K, Morey S, Millward M, Musk AWB, Lee YCG (2012) Indwelling pleural catheters reduce inpatient days over pleurodesis for malignant pleural effusion. Chest 142(2):394–400CrossRefPubMedGoogle Scholar
  15. 15.
    Porcel JM, Lui MM, Lerner AD, Davies HE, Feller-Kopman D, Lee YC (2017) Comparing approaches to the management of malignant pleural effusions. Expert Rev Respir Med 11(4):273–284CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Pulmonology DepartmentCentro Hospitalar Vila Nova de Gaia/EspinhoVila Nova de GaiaPortugal
  2. 2.Departamento de MatemáticaFaculdade de Ciências da Universidade do Porto and Centro de Matemática da Universidade do PortoPortoPortugal

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