TREATING MALIGNANT PLEURAL EFFUSIONS COST CONSCIOUSLY

Malignant pleural effusions are associated with significant morbidity. Prompt clinical evaluation followed by aggressive treatment often res ults in successful palliation. This report summarizes the traditional and experimental approaches used in the management of malignant pleura l effusion and provides an attempt at analysis of cost comparison and resource utilization associated with the use of various sclerosing age nts. The standard sclerotherapy for malignant pleural effusions has ro utinely been performed as an inpatient procedure using a large-bore ch est tube for drainage and instillation of a sclerosing agent. Use of a small-bore catheter for drainage and pleurodesis is associated with r educed patient discomfort and appears to be feasible and equally effic acious in the ambulatory setting. Results with the ambulatory procedur e are preliminary but promising. Future comparisons with the tradition al approach will allow therapy to be based not only on efficacy, but a lso on the use and expense of related resources.