CHEST
Original Research: Pulmonary ProceduresManagement of Benign Pleural Effusions Using Indwelling Pleural Catheters: A Systematic Review and Meta-analysis
Section snippets
Search Methodology
A literature search was conducted using the electronic database engines PubMed, Cochrane database, EMBASE, and MEDLINE from January 2011 to January 2016 to identify published reports addressing outcomes in patients treated with an IPC for the treatment of pleural effusion due to benign conditions. The following words were used as the search keys: “indwelling pleural catheter,” “PleurX catheter,” “pleural catheter,” “tunneled pleural catheter,” “benign pleural effusion,” “refractory nonmalignant
Results
Based on the search criteria, we reviewed 391 records. Of the 391 records, only 30 papers were eligible for further review. Two studies were excluded because IPC was used in the management of cases with underlying hematologic malignancies and after lung transplantation.17, 18, 19 Although the post-lung-transplantation pleural effusions were benign in nature, pleurodesis would be significantly affected by the thoracic surgery, and the role of the IPC in achieving pleurodesis is questionable.
Discussion
The results of our analysis show that IPCs can be used effectively in the management of BPEs, with an estimated spontaneous pleurodesis rate of 51.3%, and could be considered in patients with refractory BPE for palliation. These results are similar to the meta-analysis conducted in a MPE population, which reported a spontaneous pleurodesis rate of 45%.33 To our knowledge, this is the first meta-analysis that addresses the use of IPC in the management of BPE. We acknowledge that the major
Conclusions
We conclude that IPC is an acceptable therapeutic option for the management of refractory pleural effusion secondary to benign conditions. The overall complication rate of IPC is comparable to the complication rate in MPE but with a longer IPC placement period. Studies of higher quality are required further to evaluate the use of IPC in the treatment of BPE.
Acknowledgments
Author contributions: K. H. is the guarantor of the paper, taking responsibility for the integrity of the work as a whole, from inception to published article. M. P., K. A., and K. H. contributed substantially to the review design, data interpretation, and writing of the manuscript. S. D., A. H. A., and M. S. contributed to the review design and data interpretation of the manuscript.
Financial/nonfinancial disclosures: The authors have reported to CHEST the following: K. H. and A. H. A. are
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FUNDING/SUPPORT: This work was supported by Roswell Park Cancer Institute and National Cancer Institute (NCI) [grant P30CA016056].