Effectiveness and safety of outpatient pleurodesis in patients with recurrent malignant pleural effusion and low performance status
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 recu...
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| Format: | Article |
| Language: | English |
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Elsevier España
2011-01-01
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| Series: | Clinics |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322011000200005 |
| _version_ | 1818254812796420096 |
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| author | Ricardo Mingarini Terra Lisete Ribeiro Teixeira Benoit Jacques Bibas Paulo Manuel Pego-Fernandes Francisco Suso Vargas Fabio Biscegli Jatene |
| author_facet | Ricardo Mingarini Terra Lisete Ribeiro Teixeira Benoit Jacques Bibas Paulo Manuel Pego-Fernandes Francisco Suso Vargas Fabio Biscegli Jatene |
| author_sort | Ricardo Mingarini Terra |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-12T17:01:55Z |
| format | Article |
| id | doaj.art-9072c4ac0b0044228fa3f022433b172f |
| institution | Directory Open Access Journal |
| issn | 1807-5932 1980-5322 |
| language | English |
| last_indexed | 2024-12-12T17:01:55Z |
| publishDate | 2011-01-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-9072c4ac0b0044228fa3f022433b172f2022-12-22T00:18:06ZengElsevier EspañaClinics1807-59321980-53222011-01-0166221121610.1590/S1807-59322011000200005Effectiveness and safety of outpatient pleurodesis in patients with recurrent malignant pleural effusion and low performance statusRicardo Mingarini TerraLisete Ribeiro TeixeiraBenoit Jacques BibasPaulo Manuel Pego-FernandesFrancisco Suso VargasFabio Biscegli JateneOBJECTIVES: 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322011000200005Pleural effusionPleurodesisOutpatient careTalcMetastatic disease |
| spellingShingle | Ricardo Mingarini Terra Lisete Ribeiro Teixeira Benoit Jacques Bibas Paulo Manuel Pego-Fernandes Francisco Suso Vargas Fabio Biscegli Jatene Effectiveness and safety of outpatient pleurodesis in patients with recurrent malignant pleural effusion and low performance status Clinics Pleural effusion Pleurodesis Outpatient care Talc Metastatic disease |
| title | Effectiveness and safety of outpatient pleurodesis in patients with recurrent malignant pleural effusion and low performance status |
| title_full | Effectiveness and safety of outpatient pleurodesis in patients with recurrent malignant pleural effusion and low performance status |
| title_fullStr | Effectiveness and safety of outpatient pleurodesis in patients with recurrent malignant pleural effusion and low performance status |
| title_full_unstemmed | Effectiveness and safety of outpatient pleurodesis in patients with recurrent malignant pleural effusion and low performance status |
| title_short | Effectiveness and safety of outpatient pleurodesis in patients with recurrent malignant pleural effusion and low performance status |
| title_sort | effectiveness and safety of outpatient pleurodesis in patients with recurrent malignant pleural effusion and low performance status |
| topic | Pleural effusion Pleurodesis Outpatient care Talc Metastatic disease |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322011000200005 |
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