Feasibility of Chemical Pleurodesis with Small Bore Catheter in Patients with Symptomatic Malignant Pleural Effusions

Objective: To investigate the feasibility of small-bore catheters in sclerotherapy of malignant pleural effusions. Conventionally, malignant pleural effusions are treated with tube pleurodesis. Recently, small-bore catheters were placed with no notable difference in results. Material and Method: Two groups of 20 patients underwent drainage of malignant pleural effusions with small and large bore catheters. In the absence of limiting complications, pleurodesis with bleomycin was performed in all patients The 30 day postpleurodesis chest radiographs were compared with primary radiographs. Complications were recorded. Results: The global success rates in the case vs. control groups, were 80% vs. 81%, with 7 (46.7%) vs. 9 (56%) complete responses, 5 (33.3%) vs. 4 (25%) partial responses, and 3 (20%) vs. 3 (19%) no response among 15 vs. 16 successful pleurodesis procedures in the two groups. Mean hospitalization days (p=0.006) and mean pleurodesis duration (p=0.005) were significantly lower in the case group. Complications in the case vs. control groups included chest pain (20% vs. 40), fever (15% vs. 25%), pneumothorax (10% vs. 5%), nausea (5% vs. 5%), and cellulitis (0% vs. 5%).Conclusion: This study continues to support a role for malignant pleural effusion pleurodesis via small-bore catheter with acceptable success rate, low discomfort, low pleurodesis and hospitalization days.