Malign plevral efüzyonlarda küçük çaplı plevral drenaj kateteri (Easydren®) ile minimal invaziv yaklaşım

Yıl 2023, Cilt: 6 Sayı: 2, 355 - 358, 31.08.2023

Hıdır Esme , Yunus Emre Erdiril

https://doi.org/10.36516/jocass.1251766

Öz

Giriş: Malign plevral efüzyonların tedavisi drenaj ve kimyasal plöredezistir. Bu çalışmadaki amacımız malign plevral efüzyon nedeniyle 8F plevral drenaj kateteri ile drenaj uyguladığımız hastalardaki işlemin başarısını ve komplikasyonlarını literatür eşliğinde tartışmaktır.
Gereç ve Yöntemler: Çalışmaya Ağustos 2020 ile Ekim 2022 tarihleri arasında malign plevral efüzyon nedeniyle 8F plevral drenaj kateteri (Easydren®) uygulanan 124 hasta dahil edildi. Tüm hastaların klinik, radyolojik ve laboratuvar bulguları otomasyon sistemi ve arşiv dosyalarından elde edildi. Hastaların yaş, cinsiyet, etyoloji, kateter drenaj sayısı ve süresi, komplikasyonlar ve hastane yatış süresi kayıt altına alındı.
Sonuç: Hastaların 67’si (%54.0) bayan, 57’si (%45.9) ise erkek idi. Yaş ortalaması 54 (31-87) idi. Yüz yirmi dört hastaya toplam 136 plevral drenaj kateteri uygulandı. Drenaj ve akciğerin tam reekspansionu 136 işlemin 125’inda (%91.9) başarılı oldu. Plevral drenaj kateterlerinin uygulanması sırasında akut cerrahi komplikasyon görülmedi. Drenaj süresi ortalama 4,6 gün (3 – 11) idi. Hastanede yatış süresi 5,7 gün (4-12) idi.
Tartışma: Küçük çaplı plevral drenaj kateterlerinin daha fazla hasta konforu ile birlikte malign plevral efüzyon drenajı için geleneksel göğüs tüpleri kadar etkili olduğu kanaatindeyiz. Takip sırasında nadiren tıkanma gibi bir dezavantaja sahip olmakla birlikte tüp torakostomiye nisbetle daha az invaziv ve daha az komplikasyona sahiptir.

Anahtar Kelimeler

Malign plevral efüzyon, Küçük çaplı kateter, Drenaj

Minimally invasive approach with small diameter pleural drainage catheter (Easydren®) in malignant pleural effusions

Öz

Aim: Treatment of malignant pleural effusions is drainage and chemical pleurodesis. Our aim in this study is to investigate the success and complications of the procedure in patients who underwent drainage with an 8F pleural drainage catheter due to malignant pleural effusion, in the light of the literature.
Material and Method: The study included 124 patients who underwent 8F pleural drainage catheter (Easydren®) for malignant pleural effusion between August 2020 and October 2022. Clinical, radiological and laboratory findings of all patients were obtained from the automation system and archive files. Age, gender, etiology, number and duration of catheter drainage, complications and hospital stay of the patients were recorded.
Results: Of the patients, 67 (54.0%) were female and 57 (45.9%) were male. The mean age was 54 (31-87). A total of 136 pleural drainage catheters were applied to 124 patients. Drainage and complete reexpansion of the lung were successful in 125 (91.9%) of 136 procedures. No acute surgical complications were observed during the application of pleural drainage catheters. The mean drainage time was 4.6 days (3 – 11). The hospital stay was 5.7 days (4-12).
Conclusion: We believe that small diameter pleural drainage catheters are as effective as conventional chest tubes for the drainage of malignant pleural effusion with greater patient comfort. Although it has the disadvantage of rarely occlusion during follow-up, it is less invasive and has fewer complications compared to tube thoracostomy.

Anahtar Kelimeler

Malignant pleural efusion, small diameter catheter, drainage

Kaynakça

• 1.Rodrîguez-Panadero F. Medical thoracoscopy. Respiration. 2008; 76(4): 363-72. https://doi.org/10.1159/000158545
• 2.DiBonito L, Falconieri G, Colautti I, et al. The positive pleural e)usion. A ret¬rospective study of cytopathologic diagnoses with autopsy confirmation. Acta Cytologica 1992; 36: 329-32.
• 3.Sarıcam M. Comparision of chest tube and intrapleural catheter aplied for benign pleural effusion. Journal of Ankara University Faculty of Medicine. 2018; 71(2): 162-5. https://doi.org/10.4274/atfm.65375
• 4.Hamad AM, Alfeky SE. Small-bore catheter is more than an alternative to the ordinary chest tube for pleural drainage. Lung India. 2021; 38: 31-5. https://doi.org/10.4103/lungindia.lungindia_44_20
• 5.Light RW. In: Pleural Diseases. 5th ed. Baltimore, MD: Lippincott, Williams and Wilkins; 2007.
• 6.Havelock T, Teoh R, Laws D, et al. BTS Pleural Disease Guideline Group. Pleural procedures and thoracic ultrasound: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010; 65(2): 61-76. https://doi.org/10.1136/thx.2010.137026
• 7.Harris A, O'Driscoll BR, Turkington PM. Survey of major complications of intercostal chest drain insertion in the UK. Postgrad Med J. 2010; 86: 68-72. https://doi.org/10.1136/pgmj.2009.087759
• 8.Miller KS, Sahn SA. Chest tubes: indications, technique management and complications. Chest 1987; 91: 258e64. https://doi.org/10.1378/chest.91.2.258
• 9.Iberti TJ, Stern PM. Chest tube thoracostomy. Crit Care Chest. 1992; 8: 879e95. https://doi.org/10.1016/S0749-0704(18)30230-6
• 10.Thethi I, Ramirez S, Shen W, et al. Effect of chest tube size on pleurodesis efficacy in malignant pleural effusion: A meta-analysis of randomized cont-rolled trials. J Thorac Dis. 2018; 10: 355-62. https://doi.org/10.21037/jtd.2017.11.134
• 11.Parulekar W, Di Primio G, Matzinger F, et al. Use of small-bore vs. large-bore chest tubes for treatment of malignant pleural effusions. Chest. 2001; 120: 19-25. https://doi.org/10.1378/chest.120.1.19
• 12.Caglayan B, Torun E, Turan D, et al. Efficacy of iodopovidone pleurodesis and comparison of small-bore catheter versus large-bore chest tube. Ann Surg Oncol. 2008; 15: 2594-9. https://doi.org/10.1245/s10434-008-0004-1
• 13.Horsley A, Jones L, White J, et al. Efficacy and complications of small-bore, wire-guided chest drains. Chest. 2006; 130: 1857-63. https://doi.org/10.1378/chest.130.6.1857
• 14.Cafarotti S, Dall'Armi V, Cusumano G, et al. Small-bore wire-guided chest drains: Safety, tolerability, and effectiveness in pneumothorax, malignant ef¬fusions, and pleural empyema. J Thorac Cardiovasc Surg. 2011; 141: 683-7. https://doi.org/10.1016/j.jtcvs.2010.08.044
• 15.Yildirim E, Dural K, Yazkan R, et al. Rapid pleurodesis in symptomatic ma¬lignant pleural effusion. Eur J Cardiothorac Surg. 2005;27: 19-22. https://doi.org/10.1016/j.ejcts.2004.08.034
• 16.Tan C, Sedrakyan A, Browne J, et al. The evidence on the effectiveness of management for malignant pleural effusion: A systematic review. Eur J Car¬diothorac Surg. 2006; 29: 829-38. https://doi.org/10.1016/j.ejcts.2005.12.025
• 17.Saffran L, Ost DE, Fein AM, et al. Outpatient pleurodesis of malignant ple-ural effusions using a small-bore pigtail catheter. Chest. 2000; 118: 417-21. https://doi.org/10.1378/chest.118.2.417
• 18.Musani AI, Haas AR, Seijo L, et al. Outpatient management of malignant pleural effusions with small-bore, tunneled pleural catheters. Respiration. 2004; 71: 559-66. https://doi.org/10.1159/000081755
• 19.Herlihy JP, Loyalka P, Gnananandh J, et al. Pleurx catheter for the mana-gement of refractory pleural effusions in congestive heart failure. Tex Heart Inst J. 2009; 36: 38-43.
• 20.Dresler CM, Olak J, Herndon JE, et al. Cooperative Groups Cancer and Le-ukemia Group B; Eastern Cooperative Oncology Group; North Central Coo¬perativ Oncology Group; Radiation Therapy Oncology Group. Phase III in¬tergroup study of talc poudrage vs. talc slurry sclerosis for malignant pleural effusion. Chest. 2005; 127: 909-15. https://doi.org/10.1378/chest.127.3.909
• 21.Staes W, Funaki B. "Ex vacuo" pneumothorax. Semin Intervent Radiol. 2009; 26: 82-5. https://doi.org/10.1055/s-0029-1208386
• 22.Kim YS, Susanto I, Lazar CA, et al. Pneumothorax exvacuo or "trapped lung" in the setting of hepatic hydrothorax. BMC Pulm Med. 2012; 12: 78. https://doi.org/10.1186/1471-2466-12-78
• 23.Kopman DJ, Reddy CB, DeCamp MM, et al. Management of malignant ple-ural effusions. An Official ATS/STS/STR clinical practice guideline. Am J Res¬pir Crit Care. Med 2018; 198: 839-49. https://doi.org/10.1164/rccm.201807-1415ST
• 24.Davies HE, Davies RJ, Davies CW: BTS Pleural Disease Guideline Group. Management of pleural infection in adults: British thoracic society pleural disease guideline 2010. Thorax. 2010; 65: 41-53. https://doi.org/10.1136/thx.2010.137000