Observational studyBMJ open respiratory research2026
Management of malignant pleural effusions using an indwelling tunnelled pleural catheter and non-vacuum collection system.
Observational study in BMJ open respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
backgroundIndwelling tunnelled pleural catheters (TPCs) are a minimally invasive way to palliate symptoms for patients with recurrent symptomatic malignant pleural effusions. Current data on TPCs have used vacuum-assisted drainage systems. Gravity-based drainage systems may represent an alternative approach with improvement in patient symptoms, but have a smaller overall footprint and a decreased cost. We therefore aimed to understand the efficacy, complication rate and spontaneous pleurodesis rate of a TPC that uses a non-vacuum-assisted drainage system.
methodsThis is a prospective, observational study of 40 patients who underwent placement of a TPC with a non-vacuum-assisted drainage system for management of recurrent symptomatic malignant pleural effusions. The primary outcome of interest was dyspnoea as assessed by a 100 mm Visual Analogue Scale for Dyspnoea (VAS-Dyspnoea) at 2 weeks following insertion. Secondary outcomes included catheter-related complications and spontaneous pleurodesis. Patients were seen in follow-up at 2 weeks post-catheter placement and then every 6 weeks.
resultsAmong 40 patients who underwent TPC placement, the median age was 64 years, 65% were female, 80% were white and 20% were black. At baseline, participants had a median VAS-Dyspnoea score of 43 mm and at 2 weeks, participants (n=24) had a median VAS-Dyspnoea score of 16 mm (IQR: 6, 50) (p=0.07). A total of 19 (47.5%) patients experienced some form of TPC-related complication. A total of 15 (37.5%) achieved pleurodesis at a median of 55 days following catheter placement.
conclusionsIn this single-centre, prospective cohort of patients with recurrent symptomatic malignant pleural effusions, TPCs with a non-vacuum-assisted drainage showed a trend towards improvement in dyspnoea with complications and pleurodesis similar to vacuum-based TPC systems.
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