TREATMENT OF MALIGNANT PLEURAL EFFUSION - PLEURODESIS USING A SMALL PERCUTANEOUS CATHETER - A PROSPECTIVE RANDOMIZED STUDY

The aim of this prospective, randomized study was to investigate the p ossibility of performing pleurodesis using a small percutaneous cathet er (Cystofix(R) catheter, CH10, 65 cm) inserted at bedside in patients with recurrent malignant pleural effusion and to compare this cathete r with a conventional large bore chest tube (CH24) placed in connectio n with diagnostic thoracoscopy. After drainage pleurodesis was perform ed with tetracycline as sclerosing agent. Of 18 evaluable consecutive patients (mean age 67.8 years) nine were randomized for pleurodesis wi th the small and nine for the large catheter. In the former group, the majority (seven of nine) did not find insertion of the catheter more unpleasant than thoracentesis. In the latter group only a few (two of nine) found insertion comparable with thoracentesis (P<0.05). All pati ents found the presence of the large catheter very or somewhat unpleas ant (two and seven patients), whereas this was only the case for a few (no and two patients) treated with the small catheter (P<0.05). In th e former group three patients required new thoracentesis, whereas this was only the case for two patients in the latter group (P>0.05). No c omplications were seen. We conclude that pleurodesis in patients with recurrent malignant pleural effusion can be performed with a small per cutaneous catheter (Cystofix(R)) with an effect similar to that obtain ed with a large-bore chest tube and with less discomfort for the patie nt.