Pleurx

Pneumothorax ex vacuo (PEV) is a rare type of pneumothorax that occurs when air enters the pleural space in the chest cavity due to an increase in the volume of the lungs or a reduction in the volume of the surrounding lung tissue. Unlike a typical pneumothorax, which involves the collapse of the lung due to air accumulation, pneumothorax ex vacuo occurs when the lung itself cannot expand properly, often due to underlying lung disease or conditions such as pulmonary fibrosis or atelectasis. The mechanism is compensatory to the lung entrapment...

OBJECTIVES: Fibrinolytic therapy can be effective for management of complex pleural effusions. Tissue plasminogen activator (tPA, 10 mg) and deoxyribonuclease (DNAse) every 12 h with a dwell time of one hour is a common strategy based on published data. We used a simpler protocol of tPA (4 mg) without DNAse but with a longer dwell time of 12 h, repeated daily. We reviewed our results. METHODS: Charts were reviewed and demographics, clinical data and treatment information were abstracted...

Anomalous origin of the right coronary artery originating from the pulmonary trunk (ARCAPA) is a rare congenital coronary anomaly that is usually diagnosed incidentally. Although usually asymptomatic, ARCAPA can lead to myocardial ischemia of the left ventricular wall and/or sudden cardiac arrest. Here, we report the case of a 48-year-old female who presented for recurrent malignant pleural effusion, who was scheduled for a bronchoscopy, thoracoscopic evaluation of left pleural effusion, multiple excisional biopsies of the left chest wall and costophrenic parietal pleural nodules, and insertion of tunneled PleurX™ catheter (Becton, Dickinson and Company, Franklin Lakes, New Jersey, United States)...

BACKGROUND: Indwelling pleural catheters are frequently used for the treatment of malignant pleural effusion. The PleurX catheter (Becton, Dickinson and Company) is a commonly used indwelling pleural catheter across Canada. The traditional PleurX catheter is designed with a long segment of tubing outside of the patient's chest, making insertion, drainage, and dressing changes awkward. Our clinic developed a novel, shortened, PleurX catheter that is easier to handle. METHODS: We conducted retrospective chart review for all patients treated with a shortened PleurX catheter at our center from December 2015 to May 2019 and demographics, clinical information, and complications were recorded retrospectively...

In this case report, we describe the novel use of a permanent indwelling catheter (PiC) in the management of refractory malignant pericardial effusion (PE). The patient had disseminated lung cancer and was hospitalised repeatedly with circulatory collapse due to malignant PE despite treatments with pericardiocentesis (PCC) and a pericardial window (PW). The PiC was inserted as a last resort with no complications and was a mediator of pericardiodesis (PCD), resulting in the cease of PE. The PiC could subsequently be removed, and there was no relapse of PE...

AIM: To investigate the impact on patient outcomes, costs, and resources/infrastructure of inserting indwelling peritoneal catheters (IPC) during a day-case instead of an inpatient service. MATERIALS AND METHODS: A single-centre, retrospective analysis of patients receiving IPCs over a 4-year period was performed. Patients undergoing a day-case procedure were admitted in the morning for pre-procedural investigations, a 15.5 F PleurX IPC (BD, Wokingham, UK) was inserted, all accessible fluid drained and patients discharged the same day, barring any complications...

Angioimmunoblastic T-cell lymphoma (AITL) is an uncommon type of cluster of differentiation (CD)4 T-cell peripheral lymphoma. The varied clinical presentations of AITL present a challenge for accurate diagnosis. We present a case of a 57-year-old female with a history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in May 2020, who presented to the hospital in the summer of 2021 with shortness of breath for 3 months. She underwent an extensive workup for lymphadenopathy while in Canada involving multiple core lymph node biopsies, which were inconclusive...

Objectives: To compare outcomes of PleurX and peritoneal port for malignant ascites. Design: Retrospective review of medical records was conducted. Setting/Subjects: Subjects were consecutive patients receiving PleurX or peritoneal port for malignant ascites in a center in Sydney, Australia. Measurements: Demographic data, complication rates, hospitalization rates, and survival were measured. Results: Sixteen cases were analyzed: 6 had peritoneal port (170 catheter days) and 10 had PleurX (477 catheter days)...

Background: Treatment of refractory ascites remains challenging. We evaluated the safety and efficacy of permanent tunneled peritoneal catheters (PTPC) in this condition. Methods: We retrospectively analyzed consecutive patients in palliative situations in a tertiary referral center. Safety parameters, symptom relief, and survival were assessed. Results: Seventy patients were included from February 2012 to January 2021. Ninety percent had ascites due to malignancy, 10% due to end-stage liver disease. The technical procedure was successful in all cases; no deaths occurred...

Hepatic hydrothorax is a rare complication of chronic liver disease. It usually occurs in patients with advanced liver disease, portal hypertension, and ascites. On a rare instance, it may be the index presentation of chronic liver disease. Hepatic hydrothorax occurs in approximately 5-6% of patients with cirrhosis. The exact mechanism has not been well defined, but it is frequently thought to be due to the direct passage of ascitic fluid from the peritoneal cavity through the diaphragmatic defects. Treatment involves salt and water restriction and diuretics...

Treatment of recurrent malignant ascites in cancer patients is a challenge. Evidence based guidelines regarding the best treatment strategy are lacking. The aim of this prospective study was to investigate the safety and efficacy of a tunnelled peritoneal catheter (PleurX) in cancer patients with symptomatic ascites. Patients with symptomatic, diuretics-refractory ascites and indication for the implantation of a tunnelled peritoneal PleurX catheter were prospectively enrolled between August 2018 and July 2020...

BACKGROUND:  Chylothorax is a multifactorial complication, usually caused by surgery or traumatic injury, and more rarely by malignant disease. Because of the lack of prospective, randomised trials, the evidence-based treatment rests upon personal experience, but ideally taking into account retrospective analysis. MATERIAL AND METHODS:  The aim of this review is to provide a comprehensive overview of the currently available modern treatment options. Another aspect is to show their advantages and disadvantages...

No abstract text is available yet for this article.

BACKGROUND AND OBJECTIVES: Refractory ascites markedly worsens prognosis in cirrhosis. Large volume paracentesis (LVP) is standard treatment, but complications are common. In a randomized controlled case-series, we assessed a permanent tunneled peritoneal catheter versus LVP in patients with cirrhosis and ascites. MATERIALS AND METHODS: Random allocation was computer-generated, and concealment used opaque envelopes. Patients were included from January 2017 to December 2018...

No abstract text is available yet for this article.

INTRODUCTION: Malignant solitary fibrous tumor (MSFT) of the diaphragm is extremely rare, and to the best of our knowledge, only three cases have been reported in the past two decades. In all these cases, the diaphragms were usually reconstructed with artificial diaphragm patch because of the extensive resection. PATIENT CONCERNS: We reported a male patient with complaints of dyspnea, chest pain and massive pleural effusion in the left chest detected by chest X-ray...

The PleurX catheter was developed to facilitate long-term intermittent drainage of malignant pleural effusion or ascites. For palliation, it is important that the process of insertion is safe and that this catheter remains complicationfree so as to improve end-of-life quality. We show that this catheter can be safely inserted and discuss methods to reduce infection, which was the most common complication. Our article hopes to enlighten clinicians, patients and their caregivers of this device as a treatment option in palliative patients...

BACKGROUND: Chylothorax is a multifactorial complication, usually caused by surgery or traumatic injury, and more rarely by malignant disease. Because of the lack of prospective, randomised trials, the evidence-based treatment rests upon personal experience, but ideally taking into account retrospective analysis. MATERIAL AND METHODS: The aim of this review is to provide a comprehensive overview of the currently available modern treatment options. Another aspect is to show their advantages and disadvantages...

Crizotinib is a first line treatment for patients with non-small cell lung cancer (NSCLC) harboring translocations in anaplastic lymphoma kinase (ALK). The current gold standard for determining ALK status is fluorescence in-situ hybridisation (FISH), but immunohistochemistry (IHC) is becoming increasingly popular due to lower cost. There are currently few reports on clinical outcomes with crizotinib therapy in patients who have tested negative by FISH and positive by IHC. A 53 year old lifelong non-smoking, physically active male with newly diagnosed Stage IV NSCLC presented with shortness of breath on exertion one month prior to referral...

BACKGROUND: Malignant pleural effusion (MPE) complicates many neoplasms and its incidence is expected to rise in parallel with the aging population and longer survival of cancer patients. Although a clear consensus exists on indwelling catheters in patients with poor performance status, no study has hitherto compared different devices in patients requiring temporary or definitive drainage following talc poudrage. METHODS: This is a prospective, two-arm, pilot study on patients with MPE undergoing talc poudrage, comparing two different catheters (PleurX® versus Pleurocath® ) positioned because of the inefficacy of the procedure or the high risk of short-term failure...