A minimal invasive approach in pleural effusions: cystofix catheter

Yıl 2016, Cilt: 7 Sayı: 1, 5 - 9, 24.02.2016

Yücel Akkaş , Özgür Kantarcıoğlu Ebru Atasever Akkaş , Ekber Şahin

Öz

Aim: Recently, catheters with small diameter are getting popularity in the treatment of pleural effusions. In this study, patients with cystofix catheter mounted for pleural effusion drainage were evaluated in terms of age, gender, underlying pathology, efficacy of treatment and complications.

Material and Methods: Data of the 59 patients treated with cystofix catheter due to pleural effusion were evaluated retrospectively. 14 F catheter was applied under local anesthesia from the 7th or the 8th intercostal space dorsal axillary line to patients with massive pleural effusion.

Results: The average age was 65.9 ± 13.9 and 37 (62.7%) of patients were male. 11 (18.6%) of the cases were having malign and 48 (81.4%) were having benign etiologies. Etiologic reasons were congestive right heart failure in 30 (50.8%) cases, parapneumonic effusion in 14 (23.7%) cases and primary bronchial carcinoma in 6 (10.2%) cases.

Conclusion: The results obtained from this study suggested that cystofix catheter can be used as an alternative minimal invasive technique in benign and malign effusion drainage, because of its small diameter, being easily available and applicable, avoiding clogging and being appropriate for pleurodesis.

 

Key Words: Pleural effusion, catheters, minimally invasive surgical procedures, heart failure

Anahtar Kelimeler

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Plevral effüzyonlarda minimal invaziv bir yaklaşım: sistofiks kateter

Öz

Amaç: Günümüzde plevral effüzyon tedavisinde küçük çaplı katater kullanımı daha popüler bir uygulama haline gelmiştir. Bu çalışmada plevral effüzyon drenajı için sistofix katater takılmış hastalar yaş, cinsiyet, altta yatan patoloji, tedavi etkinliği ve komplikasyonlar açısından değerlendirildi.

Gereç ve Yöntemler: Plevral effüzyon nedeniyle sistofix kataterle tedavi edilen 59 hastanın verileri retrospektif olarak değerlendirildi. Masif plevral effüzyonlu hastalara lokal anestezi altında arka axiller hat 7. veya 8. interkostal aralıktan 14 F katater uygulandı.

Bulgular: Hastaların ortalama yaşı 65,9 ± 13,9 ve 37’si (%62,7) erkek idi. Vakaların etiyolojilerinin 11’i (%86) malign ve 48’i (%81,4) benign idi. Etiyolojik nedenler 30’unda (%50,8) konjestif sağ kalp yetmezliği, 14’ünde (%23,7) parapnömonik effüzyon ve 6’sında (%10,2) primer bronş kanseri idi.

Sonuçlar: Elde edilen bulgular, sistofix kataterin, küçük çaplı olması, kolay elde edilebilir ve uygulanabilir olması, tıkanmaması ve plöredez için uygun olmasından dolayı, benign ve malign effüzyon drenajında alternatif minimal invaziv bir teknik olduğunu desteklemektedir.

 

Anahtar Kelimeler: Plevral effüzyon, kataterler, minimal invazif cerrahi yöntemler, kalp yetmezliği

Anahtar Kelimeler

Plevral effüzyon, kataterler, minimal invazif cerrahi yöntemler, kalp yetmezliği

Kaynakça

• Olden AM, Holloway R. Treatment of malignant pleural effusion: PleuRx catheter or talc pleurodesis? A cost-effectiveness analysis. J Palliat Med 2010; 13: 59-65.
• McLoud TC, Flower CD. Imaging of the pleura: sonography, CT and MR imaging. AJR 1991; 156: 1145-53.
• Putnam JB Jr, Walsh GL, Swisher SG et al. Outpatient management of malignant pleural effusion by a chronic indwelling pleural catheter. Ann Thorac Surg 2000; 69: 369-75.
• Herlihy J, Loyalka P, Gnananandh J et al. PleurX catheter for the management of refractory pleural effusions in congestive heart failure. Tex Heart Inst J 2009; 36: 38-43.
• Yuncu G. Malign plevral effüzyonlarda invaziv girişimler ile plöredez. Solunum 2001; 3: 236-40.
• Kiliç D, Findikcioglu A, Hatipoglu A. Description of a new technique: management of pleural effusion with a Cystofix catheter. Respirology 2007; 12: 288-90.
• Ben-Nun A, Best LA. A simple method of using a Foley catheter to drain pleural effusion. Surg Today 2008; 38: 769-70.
• Tremblay A, Michaud G. Single-center experience with 250 tunnelled pleural catheter insertions for malignant pleural effusion. Chest 2006; 129: 362-8.
• Dongel I, Bayram M. Toraksa göğüs tüpü ve sistofix uygulanan 64 hastanın değerlendirilmesi. TAD 2012; 10: 1-5.
• Cafarotti S, Dall’Armi V, Cusumano G et al. Small bore wire-guided chest drains: safety, tolerability, and effectiveness in pneumothorax, malignant effusions, and pleural empyema. J Thorac Cardiovasc Surg 2011; 141: 683-7.
• Light RW. Pleural controversy: optimal chest tube size for drainage. Respirology 2011; 16: 244-8.
• Fysh ET, Smith NA, Lee YC. Optimal chest drain size: the rise of the small-bore pleural catheter. Semin Respir Crit Care Med. 2010; 31: 760-8.
• Benton IJ, Benfield GFA. Comparison of a large and small-calibre tube drain for managing spontaneous pneumothoraces. Resp Med 2009; 103: 1436-40.
• Laub M, Milman N, Muller D, Struve-Christensen E. Role of small caliber chest tube drainage for iatrogenic pneumothorax. Thorax 1990; 45: 748-9.
• Milman N, laub MS, Müller DM, Struve-Christensen E. Iatrogenic pneumothorax treated with a small caliber pleural tube. Ugeskr Laeger 1991; 153: 978-80.