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Malignant pleural effusion management

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10 papers 100 to 500 followers
By Jason Mann No BS pulmonary critical care fellow
Christopher R Gilbert, Hans J Lee, Joseph H Skalski, Fabien Maldonado, Momen Wahidi, Philip J Choi, Jamie Bessich, Daniel Sterman, A Christine Argento, Samira Shojaee, Jed A Gorden, Candice L Wilshire, David Feller-Kopman, Ricardo Ortiz, Bareng Aletta Sanny Nonyane, Lonny Yarmus
BACKGROUND: Malignant pleural effusion is a common complication of advanced malignancies. Indwelling tunneled pleural catheter (IPC) placement provides effective palliation but can be associated with complications, including infection. In particular, hematologic malignancy and the associated immunosuppressive treatment regimens may increase infectious complications. This study aimed to review outcomes in patients with hematologic malignancy undergoing IPC placement. METHODS: A retrospective multicenter study of IPCs placed in patients with hematologic malignancy from January 2009 to December 2013 was performed...
September 2015: Chest
B Jayakrishnan, Babar Dildar, Dawar M Rizavi, Saif M Al Mubaihsi, Adil Al Kindi
No abstract text is available yet for this article.
August 22, 2015: Lancet
Justin M Thomas, Ali I Musani
Malignant pleural effusions are a cause of significant symptoms and distress in patients with end-stage malignancies and portend a poor prognosis. Management is aimed at symptom relief, with minimally invasive interventions and minimal requirement for hospital length of stay. The management options include watchful waiting if no symptoms are present, repeat thoracentesis, medical or surgical thoracoscopic techniques to achieve pleurodesis, pleuroperitoneal shunts, placement of tunneled pleural catheters, or a combination of modalities...
September 2013: Clinics in Chest Medicine
Richard K Freeman, Anthony J Ascioti, Raja S Mahidhara
BACKGROUND: Patients with a suspected malignant pleural effusion occasionally require thoracoscopy to achieve a diagnosis. It is unclear whether chemical pleurodesis or the placement of a tunneled pleural catheter (TPC) that can be used for intermittent pleural drainage produces superior palliation, a shorter hospital stay, and less morbidity. This investigation compares these 2 treatment groups. METHODS: Patients with a recurrent, symptomatic, pleural effusion suspected of having a malignant etiology who underwent a thoracoscopic exploration after at least 2 nondiagnostic thoracenteses were identified...
July 2013: Annals of Thoracic Surgery
Richard W Light
No abstract text is available yet for this article.
July 2012: Chest
Pyng Lee
No abstract text is available yet for this article.
July 2012: Chest
Helen E Davies, Eleanor K Mishra, Brennan C Kahan, John M Wrightson, Andrew E Stanton, Anur Guhan, Christopher W H Davies, Jamal Grayez, Richard Harrison, Anjani Prasad, Nicola Crosthwaite, Y C Gary Lee, Robert J O Davies, Robert F Miller, Najib M Rahman
CONTEXT: Malignant pleural effusion causes disabling dyspnea in patients with a short life expectancy. Palliation is achieved by fluid drainage, but the most effective first-line method has not been determined. OBJECTIVE: To determine whether indwelling pleural catheters (IPCs) are more effective than chest tube and talc slurry pleurodesis (talc) at relieving dyspnea. DESIGN: Unblinded randomized controlled trial (Second Therapeutic Intervention in Malignant Effusion Trial [TIME2]) comparing IPC and talc (1:1) for which 106 patients with malignant pleural effusion who had not previously undergone pleurodesis were recruited from 143 patients who were treated at 7 UK hospitals...
June 13, 2012: JAMA: the Journal of the American Medical Association
Ben M Hunt, Alexander S Farivar, Eric Vallières, Brian E Louie, Ralph W Aye, Eva E Flores, Jed A Gorden
BACKGROUND: A malignant pleural effusion (MPE) is a late complication of malignancy that affects respiratory function and quality of life. A strategy for palliation of the symptoms caused by MPE should permanently control fluid accumulation, preclude any need for reintervention, and limit hospital length of stay (LOS). We compared video-assisted thorascopic (VATS) talc insufflation with placement of a tunneled pleural catheter (TPC) to assess which intervention better met these palliative goals...
October 2012: Annals of Thoracic Surgery
Paul MacEachern, Alain Tremblay
Malignant pleural effusions (MPE) are a common complication of advanced malignancy. The treatment of MPE should be focused on palliation of associated symptoms. The traditional approach to MPE has been to attempt pleurodesis by introducing a sclerosant into the pleural space. A more recent development in the treatment of MPE has been the use of indwelling pleural catheters (IPC) for ongoing drainage of the pleural space. Controversy exists as to which approach is superior. Pleurodesis approaches will have the advantage of a time-limited course of treatment and high pleurodesis rate at the cost of a more invasive procedure requiring a general anaesthetic or conscious sedation (for thoracoscopic approaches) and an inpatient hospital stay...
July 2011: Respirology: Official Journal of the Asian Pacific Society of Respirology
Jared L Antevil, Joe B Putnam
No abstract text is available yet for this article.
October 2007: Annals of Surgical Oncology
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