Management of Malignant Pleural Effusion - Indwelling Pleural Catheter or Talc Pleurodesis
Pleural Effusion, Malignant, Lung Neoplasms
About this trial
This is an interventional treatment trial for Pleural Effusion, Malignant focused on measuring malignant pleural effusion,talc pleurodesis,quality of life
Eligibility Criteria
Inclusion Criteria:
Patients with recurrent symptomatic pleural effusion, the diagnosis was obtained by : - positive cytology for malignant cells in the fluid.
- patients well known for malignancy, with exudative pleural effusion with no alternative diagnosis.
- pleural biopsy - surgically obtained - with diagnosis of pleural malignancy
- microscopic intraoperative findings suggestive of pleural malignancy.
- Patients who underwent prior to involvement in the study, draining of the pleural fluid with symptomatic improvement.
- Patients with rate of fluid accumulation less than 30 days.
- Patient who signed informed consent about being involved in the study.
Exclusion Criteria:
- Patients under the age of 18 years.
- Female patients who are Pregnant or nursing.
- Patients with rate of pleural effusion accumulation is more than 30 days.
- Patients who didn't show clinical improvement post proper draining of the fluid
- Patients who are hemodynamically or respiratory unstable.
- Patients with Empyema.
- Patients who are non functioning/ not active according to the Performance status.
- The type of malignancy which cause the malignant pleural effusion is Lymphoma.
- Patient who underwent pneumonectomy at the side of the fluid.
- previous pleurodesis at the side of pleural effusion.
- Chylothorax in the initial pleural tapping.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Talc Pleurodesis
Indwelling Pleural Catheter
For patients in this group, chest tube type PIGTAIL 10 - 14 Fr will be inserted by by chest ultrasound guided and under local anesthesia, allowing good draining of the hemithorax, in case of fluid discharges less than 250 cc/24, talc pleurodesis will be performed, chest tube will be removed 24 - 48 hours later on. the patient will be admitted in the hospital during the whole procedure course. If the patient developed non expanded - trapped lung post chest tube insertion, or if he had persistence high chest tube output for more than 10 days, then the patient will remain with the PIGTAIL as an Indwelling Pleural Catheter.
All patients from this group will have Indwelling Pleural Catheter insertion type PLEURAX inserted by ultrasound guided and under local anesthesia. the patient and his/her family will be instructed and educated about the proper way of using the catheter, and how to perform pleural draining at home. the duration of treatment with the Pleurax depends on the rate and amount of pleural effusion draining.