Abstract
Inserting a tunneled pleural catheter is a valid option in palliative treatment of malignant pleural effusion. The procedure is not simple and the cost of special pleural catheters is relatively high. We have tried a less invasive approach: In selected cases, we have used skin elasticity to introduce a tunneled pleural catheter.
Method: Pleural effusion was assesed by ultrasound. During evaluation, skin of the patient was moved upwards (possible in patients with kachexia) and fixed in this position. Under aseptic conditions and in local anesthesia, a small-bore catheter was introduced to pleural space and fixed to the skin. The catheter was then tunneled by moving the skin back downwards.
Case series (retrospective analysis) and results: In 32 patients, we tunneled 37 chest catheters. Lenght of tunnelisation was more than 4cm in 24 of the procedures, longest tunnelisation was 9cm. There were no early complications associated with the insertion method. Median time of drainage was 16 days. In 7 patients, cathetrisation was longer than one month. 11 patients were dismissed with pleural catheter, 9 were transfered to other department. Complications: Dislocation in 4 cases, obturation in 2 cases, flegmona in 3 cases, infection of pleural space in 2 cases.
Conclusion: Atypical tunneling of pleural catheter might be a promising alternative to other treatment options in symptomatic pleural effusion.
- Copyright ©the authors 2017