Indwelling pleural catheter removals in a large volume centre in the North East of England.
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Authors
Aujayeb, Avinash
Issue Date
2021
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Abstract
"Background: Indwelling pleural catheters (IPCs) help in pleural effusion management and are removed. Locally, all removals are done in theatre, with pre-operative antibiotics. Talc is not instilled and aggressive drainage is not pursued.
Methods: With Caldicott approval, a retrospective review of IPCs removed between Jan 2015 and Oct 2020 was conducted. Basic demographics, clinical details and outcomes were collected. Descriptive statistical methodology was applied.
Results: Total number of IPCs performed was 229. IPCs removed numbered 63, (27.5%). 37 (58.7%) were male. Performance status was 0 (22), 1 (25), 2 (10) and 3 (6). Diagnoses were benign fibrinous pleuritis (5), liver failure (1), heart failure (1), mesothelioma (18), lung cancer (14), breast cancer (11), other cancers (9) and unexplained effusions (4). Median time to removal was 183 days (IQR: 98–265; range: 27 to 434). Pleural fluid cytology was not sent in 1, inconclusive in 8, suspicious in 1, negative in 28 (mean time to removal 187 days) and positive in 25 (mean 193) [p = 0.66]. Non-expandable lung was present in 58 (92%). 37 had chemotherapy, 3 after IPC removal only. There was no difference in time to removal between those groups. [34 (mean 183 days) vs. 26 (195), p = 0.26]. There was no infection before removal. Mean days to removal with loculations was 151 (n = 17) vs. 195 (n = 46) with no loculations [p ?0 .05]. 2 IPCs fractured (distal end of 1 was cut as it could not be removed). 1 patient developed post removal cellulitis. None needed further interventions.
Conclusions: Removal is more likely in the absence of lung entrapment, in patients with good (PS) and loculations. Treatment with chemotherapy with an IPC in situ and positive cytology are not associated with reduced time to IPC removal. Failure to remove is less than 5%."
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Citation
Aujayeb, A. (2021) 202P Indwelling pleural catheter removals in a large volume centre in the North East of England. Journal of Thoracic Oncology; 16 (4) : S807
Publisher
Journal of Thoracic Oncology
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1556-0864