Use of a Pleural Implantable Access System for the Management of Malignant Pleural Effusion: The Institut Curie Experience
| Autor: | Sophie Di Maria, Irène Kriegel, Alain Livartowski, Regine Levesque, Catherine Daniel, Marc Esteve, Gabriela Patrubani |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Palliative care Adolescent medicine.medical_treatment Thoracentesis Severity of Illness Index Catheterization Catheters Indwelling Port (medical) Recurrence medicine Humans Malignant pleural effusion Prospective Studies Aged Aged 80 and over business.industry Palliative Care Equipment Design Middle Aged Pleural cavity medicine.disease Pleural Effusion Malignant Surgery Catheter Pneumonia Treatment Outcome medicine.anatomical_structure Equipment and Supplies Drainage Female Safety Cardiology and Cardiovascular Medicine business Pleurodesis Follow-Up Studies |
| Zdroj: | The Annals of Thoracic Surgery. 84:1367-1370 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2007.04.037 |
| Popis: | Purpose Malignant pleural effusion has a very poor prognosis, raises problems of medical management, and impairs quality of life. The authors report the first experience of a pleural implantable access system for the treatment of recurrent symptomatic malignant pleural effusion. Description Prospective follow-up of 29 patients between August 20, 2005 and August 1, 2007 in a single center. Thirty-four pleural implantable access systems were placed in 29 patients (23 patients with breast cancers, 4 patients with bilateral placements, and 1 patient with a replacement) under sedation after the decision of a multidisciplinary meeting. Evaluation Twenty-eight patients obtained partial or complete relief of their dyspnea. Six patients underwent pleurodesis after a maximum of 2 months. Fifteen patients were receiving chemotherapy at the time of placement. Seven patients died at the Institut Curie or in a palliative care unit without returning home. The other 22 patients presented a total of 280 days of hospitalization for 2,717 days of catheter implantation. No placement failures were observed in this series. Two infectious complications (infectious pneumonia and skin infection over the puncture site) and two mechanical complications (expulsion of the port and disconnection between the port and the catheter) were observed and easily treated. One patient had loculation of the pleural cavity develop after 16 thoracenteses making further thoracentesis ineffective. Conclusions The pleural implantable access system is an interesting alternative in terms of efficacy and safety for the outpatient management of malignant pleural effusion. It presents a number of advantages in terms of comfort and infectious risk compared with tunnelled pleural catheters. |
| Databáze: | OpenAIRE |
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