Title: Tunnelled indwelling pleural catheters inserted post thoracoscopy
Abstract: <b>Introduction:</b> Were we to be aware at thoracoscopy which patients would benefit from a tunnelled indwelling pleural catheter (TIPC), we could perform both procedures simultaneously thus simplifying the treatment pathway for the patient and potentially relieving breathlessness earlier. <b>Aim:</b> To evaluate the frequency of post-thoracoscopy TIPC insertion and describe this cohort of patients. <b>Method:</b> Data was collected regarding the diagnosis, duration of TIPCs and complications for patients who underwent thoracoscopy and TIPC insertion at the Royal Gwent Hospital from October 2010 to November 2019. <b>Results:</b> 349 patients had thoracoscopy during the time period whilst 151 patients had TIPCs inserted, of which 51 (34%) were inserted post thoracoscopy and 4 at thoracoscopy. The mean time between thoracoscopy and TIPC insertion was 65 days. 36% of all thoracoscopy patients with mesothelioma had a TIPC, compared to 16% of patients with other malignancies. 21 TIPCs were inserted within 30 days of thoracoscopy; of these, 13 had mesothelioma, 9 had talc at thoracoscopy, and 10 had visible non-expandable lung (NEL) at thoracoscopy. 20 patients had their TIPC removed due to pleurodesis, and 4 due to localised infection. The average duration of a non-infected TIPC was 105 days. 26 (47%) patients died with a TIPC in situ with an average time from insertion to death of 109 days. <b>Conclusion:</b> The 21 patients who had a TIPC inserted within 30 days of thoracoscopy would have benefitted most from having simultaneous procedures. We could consider inserting a TIPC at thoracoscopy when there is a high index of suspicion for both mesothelioma and NEL. The availability of pleural manometry may aid this decision.
Publication Year: 2020
Publication Date: 2020-09-07
Language: en
Type: article
Indexed In: ['crossref']
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