Use of small-bore vs large-bore chest tubes for treatment of malignant pleural effusions

W. Parulekar, G. Di Primio, F. Matzinger, C. Dennie, Robert G Bociek

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

Study objective: To evaluate the efficacy of small-bore (12 French vanSonnenberg) catheters compared with standard large-bore chest tubes in the drainage and sclerotherapy of malignant pleural effusions. Design: Retrospective review. Setting: An academic tertiary care hospital. Patients: Adult patients with documented neoplasms and malignant pleural effusions, treated between 1986 and 1995. Intervention: All patients included in the study underwent drainage of malignant pleural effusions either by large-bore chest tube or by ultrasound-guided small-bore catheter. After drainage, pleurodesis was performed. Results: Outcome as defined by recurrence of effusion was determined by blinded examination of all postpleurodesis chest radiographs. We identified 58 cases of malignant pleural effusion in which small-bore catheters were used and 44 in which large-bore chest tubes were used. The majority of patients had breast (n = 56, 55%) or lung cancer (n = 29, 28%). The median age was 65 years. Fifty-nine patients were actively being treated with chemotherapy at the time of pleurodesis. The following sclerosing agents were used: talc, 27 (26%); tetracycline, 72 (70%); bleomycin, 2 (2%); and interferon, 1 (1%). Actuarial probabilities of recurrence at 6 weeks and 4 months were 45% and 53% for the small tubes vs 45% and 51% for the large tubes. Univariate and multivariate analyses failed to demonstrate that tube size had any influence on the rate of recurrence. Conclusions: We were unable to detect any major differences in outcomes with the use of either size of chest tube. Our study suggests that small-bore catheters may be effective in the treatment of malignant pleural effusions and deserve further evaluation in prospectively designed trials.

Original languageEnglish (US)
Pages (from-to)19-25
Number of pages7
JournalChest
Volume120
Issue number1
DOIs
StatePublished - Jan 1 2001

Fingerprint

Malignant Pleural Effusion
Chest Tubes
Catheters
Pleurodesis
Drainage
Recurrence
Sclerosing Solutions
Talc
Therapeutics
Sclerotherapy
Bleomycin
Tertiary Healthcare
Tetracycline
Tertiary Care Centers
Interferons
Lung Neoplasms
Breast
Thorax
Multivariate Analysis
Drug Therapy

Keywords

  • Chest tubes
  • Complications
  • Indwelling catheters
  • Malignant pleural effusion
  • Pleurodesis
  • Recurrence

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Use of small-bore vs large-bore chest tubes for treatment of malignant pleural effusions. / Parulekar, W.; Di Primio, G.; Matzinger, F.; Dennie, C.; Bociek, Robert G.

In: Chest, Vol. 120, No. 1, 01.01.2001, p. 19-25.

Research output: Contribution to journalArticle

Parulekar, W. ; Di Primio, G. ; Matzinger, F. ; Dennie, C. ; Bociek, Robert G. / Use of small-bore vs large-bore chest tubes for treatment of malignant pleural effusions. In: Chest. 2001 ; Vol. 120, No. 1. pp. 19-25.
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AB - Study objective: To evaluate the efficacy of small-bore (12 French vanSonnenberg) catheters compared with standard large-bore chest tubes in the drainage and sclerotherapy of malignant pleural effusions. Design: Retrospective review. Setting: An academic tertiary care hospital. Patients: Adult patients with documented neoplasms and malignant pleural effusions, treated between 1986 and 1995. Intervention: All patients included in the study underwent drainage of malignant pleural effusions either by large-bore chest tube or by ultrasound-guided small-bore catheter. After drainage, pleurodesis was performed. Results: Outcome as defined by recurrence of effusion was determined by blinded examination of all postpleurodesis chest radiographs. We identified 58 cases of malignant pleural effusion in which small-bore catheters were used and 44 in which large-bore chest tubes were used. The majority of patients had breast (n = 56, 55%) or lung cancer (n = 29, 28%). The median age was 65 years. Fifty-nine patients were actively being treated with chemotherapy at the time of pleurodesis. The following sclerosing agents were used: talc, 27 (26%); tetracycline, 72 (70%); bleomycin, 2 (2%); and interferon, 1 (1%). Actuarial probabilities of recurrence at 6 weeks and 4 months were 45% and 53% for the small tubes vs 45% and 51% for the large tubes. Univariate and multivariate analyses failed to demonstrate that tube size had any influence on the rate of recurrence. Conclusions: We were unable to detect any major differences in outcomes with the use of either size of chest tube. Our study suggests that small-bore catheters may be effective in the treatment of malignant pleural effusions and deserve further evaluation in prospectively designed trials.

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