PT  - JOURNAL ARTICLE
AU  - Guillaume Héry
AU  - Éric Dansin
AU  - Philippe Girard
AU  - Romain Corre
AU  - Guillaume Leveiller
AU  - Laurent Sohier
AU  - Hugues Morel
AU  - Eric Briens
TI  - Tunneled indwelling pleural catheter (TPC) in recurrent malignant pleural effusions: A retrospective study of 230 patients
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - P2785
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/P2785.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/P2785.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Introduction: Malignant pleural effusions (MPE) are a major problem in advance malignancy resulting in severe dyspnea, poor quality of life and reduced survival. Management must be centered on palliative care and symptom control. In recent years TPC has emerged as a new therapeutic opportunity for these patients.Objective: To describe the use of TPC, results and its potential complications in a retrospective (2007-2012) multi-centric study.Studied population : Two hundred and thirty patients (mean age 63 years [19-96] , 56% of women) with proven MPE and 241 TPC insertions. Underlying malignancy included lung cancers (35%), gynecological cancers (12%), breast cancers (31%), mesothelioma (5%). Most patients were unsuitable for talc pleurodesis (trapped lung 39.4%, lymphangitis carcinoma 13.5% or lung mass 58.3%). All had failed with previous repeated thoracocentesis and thoracoscopic talcage.Results : Dyspnea improvement was noted in 87.1% of the cases. 73% of the patients were discharged from hospital with a home drainage by a trained nurse. Mean length of hospital stay was 4,9 days. Mean length of pleural drainage was 82 days [0-489]. Spontaneous pleurodesis occurred in 13% of the cases. Early complications were mainly pneumothorax (8.2%). Late complications included locoregional infections (7.64%), poor TPC tolerance (4.2%), TPC obstruction or dislodgement (5.45%) and 1 case of tract metastasis.Conclusion: Our results show that the management of recurrent MPE by the TPC is easy and safe. This technique avoids hospitalizations for iterative thoracocentesis and improves patients symptoms with a low rate of complication.