Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Jan;26(1):70-6.
doi: 10.1007/s11606-010-1472-0. Epub 2010 Aug 10.

Efficacy and safety of tunneled pleural catheters in adults with malignant pleural effusions: a systematic review

Margaret E M Van Meter  1 , Kanako Y McKee, R Jeffrey Kohlwes
Affiliations

Efficacy and safety of tunneled pleural catheters in adults with malignant pleural effusions: a systematic review

Margaret E M Van Meter et al. J Gen Intern Med. 2011 Jan.

Abstract

Background: Malignant pleural effusions (MPE) are a frequent cause of dyspnea and discomfort at the end of cancer patients' lives. The tunneled indwelling pleural catheter (TIPC) was approved by the FDA in 1997 and has been investigated as a treatment for MPE.

Objective: To systematically review published data on the efficacy and safety of the TIPC for treatment of MPE.

Design: We searched the MEDLINE, EMBASE, and ISI Web of Science databases to identify studies published through October 2009 that reported outcomes in adult patients with MPE treated with a TIPC. Data were aggregated using summary statistics when outcomes were described in the same way among multiple primary studies.

Main measures: Symptomatic improvement and complications associated with use of the TIPC.

Key results: Nineteen studies with a total of 1,370 patients met criteria for inclusion in the review. Only one randomized study directly compared the TIPC with the current gold standard treatment, pleurodesis. All other studies were case series. Symptomatic improvement was reported in 628/657 patients (95.6%). Quality of life measurements were infrequently reported. Spontaneous pleurodesis occurred in 430/943 patients (45.6%). Serious complications were rare and included empyema in 33/1168 patients (2.8%), pneumothorax requiring a chest tube in 3/51 (5.9%), and unspecified pneumothorax in 17/439 (3.9%). Minor complications included cellulitis in 32/935 (3.4%), obstruction/clogging in 33/895 (3.7%) and unspecified malfunction of the catheter in 11/121 (9.1%). The use of the TIPC was without complication in 517/591 patients (87.5%).

Conclusions: Based on low-quality evidence in the form of case series, the TIPC may improve symptoms for patients with MPE and does not appear to be associated with major complications. Prospective randomized studies comparing the TIPC to pleurodesis are needed before the TIPC can be definitively recommended as a first-line treatment of MPE.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Article selection process. Abbreviations: WoS, Web of Science; VATS, video-assisted thoracoscopic surgery
Figure 2
Figure 2
Outcomes reported in patients treated with the TIPC
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Antony VB, Loddenkemper R, Astoul P, et al. Management of malignant pleural effusions. American Journal of Respiratory and Critical Care Medicine. 2000;162:1987–2001. - PubMed
    1. Dresler CM, Olak J, Herndon JE, 2nd, et al. Phase III intergroup study of talc poudrage vs talc slurry sclerosis for malignant pleural effusion. Chest. 2005;127:909–15. doi: 10.1378/chest.127.3.909. - DOI - PMC - PubMed
    1. Rehse DH, Aye RW, Florence MG. Respiratory failure following talc pleurodesis. Am J Surg. 1999;177:437–40. doi: 10.1016/S0002-9610(99)00075-6. - DOI - PubMed
    1. Davies HE, Lee YC, Davies RJ. Pleurodesis for malignant pleural effusion: talc, toxicity and where next? Thorax. 2008;63:572–4. doi: 10.1136/thx.2007.092940. - DOI - PubMed
    1. Michaud G, Barclay P, Tremblay A. Tunneled pleural catheters for palliation of malignant pleural effusions. Journal of Bronchology. 2005;12:245–8. doi: 10.1097/01.lab.0000185782.99433.02. - DOI

Publication types

MeSH terms