Abstract
Malignant pleural effusions are often symptomatic and tend to recur after simple aspiration. Pleurodesis may prevent recurrence of the effusion; many agents and techniques have been described. A questionnaire was sent to 448 clinicians in the United Kingdom to determine how pleurodesis is performed in practice. There was a 56% overall response, with replies from 101 respiratory physicians, 88 general physicians, 29 thoracic surgeons, and 35 general surgeons. General surgeons saw few cases of malignant pleural effusion and rarely performed pleurodesis. A patient with recurrent malignant pleural effusion would usually be managed with pleurodesis by 76 (76%) respiratory physicians, 26 (30%) general physicians, and 23 (81%) thoracic surgeons; a further 29 (33%) general physicians would refer such patients to another specialist. Most medical pleurodesis were performed by junior staff, whereas consultant thoracic surgeons were more likely to be concerned with the procedure. All the thoracic surgeons used an intercostal tube drain, usually with suction. An intercostal tube drain was used routinely by only 54 (54%) of the respiratory physicians and 28 (32%) general physicians. Thoracic surgeons preferred talc for pleurodesis whereas physicians most commonly used tetracycline. The variety of methods in use supports the need for randomised, controlled studies to determine the most effective technique of pleurodesis.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Anderson C. B., Philpott G. W., Ferguson T. B. The treatment of malignant pleural effusions. Cancer. 1974 Apr;33(4):916–922. doi: 10.1002/1097-0142(197404)33:4<916::aid-cncr2820330405>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
- Dhillon D. P., Spiro S. G. Malignant pleural effusions. Br J Hosp Med. 1983 Jun;29(6):506-8, 510. [PubMed] [Google Scholar]
- Fentiman I. S. Effective treatment of malignant pleural effusions. Br J Hosp Med. 1987 May;37(5):421, 424-8. [PubMed] [Google Scholar]
- Fentiman I. S., Millis R., Sexton S., Hayward J. L. Pleural effusion in breast cancer: a review of 105 cases. Cancer. 1981 Apr 15;47(8):2087–2092. doi: 10.1002/1097-0142(19810415)47:8<2087::aid-cncr2820470830>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
- Fentiman I. S., Rubens R. D., Hayward J. L. A comparison of intracavitary talc and tetracycline for the control of pleural effusions secondary to breast cancer. Eur J Cancer Clin Oncol. 1986 Sep;22(9):1079–1081. doi: 10.1016/0277-5379(86)90009-x. [DOI] [PubMed] [Google Scholar]
- Fentiman I. S., Rubens R. D., Hayward J. L. Control of pleural effusions in patients with breast cancer. A randomized trial. Cancer. 1983 Aug 15;52(4):737–739. doi: 10.1002/1097-0142(19830815)52:4<737::aid-cncr2820520428>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
- Fracchia A. A., Knapper W. H., Carey J. T., Farrow J. H. Intrapleural chemotherapy for effusion from metastatic breast carcinoma. Cancer. 1970 Sep;26(3):626–629. doi: 10.1002/1097-0142(197009)26:3<626::aid-cncr2820260320>3.0.co;2-3. [DOI] [PubMed] [Google Scholar]
- Good J. T., Jr, Sahn S. A. Intrapleural therapy with tetracycline in malignant pleural effusions: the importance of proper technique. Chest. 1978 Nov;74(5):602–602. doi: 10.1378/chest.74.5.602a. [DOI] [PubMed] [Google Scholar]
- Hausheer F. H., Yarbro J. W. Diagnosis and treatment of malignant pleural effusion. Semin Oncol. 1985 Mar;12(1):54–75. [PubMed] [Google Scholar]
- Leff A., Hopewell P. C., Costello J. Pleural effusion from malignancy. Ann Intern Med. 1978 Apr;88(4):532–537. doi: 10.7326/0003-4819-88-4-532. [DOI] [PubMed] [Google Scholar]
- Ostrowski M. J. An assessment of the long-term results of controlling the reaccumulation of malignant effusions using intracavity bleomycin. Cancer. 1986 Feb 15;57(4):721–727. doi: 10.1002/1097-0142(19860215)57:4<721::aid-cncr2820570407>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
- Tattersall M. H., Boyer M. J. Management of malignant pleural effusions. Thorax. 1990 Feb;45(2):81–82. doi: 10.1136/thx.45.2.81. [DOI] [PMC free article] [PubMed] [Google Scholar]