[A randomized study of small bore catheter thoracostomy closed drainage versus conventional pleural aspiration in the treatment of malignant pleural effusions].

BACKGROUND: Malignant pleural effusions commonly occur in patients with advanced cancer. Treatment is often palliative, such as pleural aspiration or tube thoracostomy with large bore chest tube. Tube thoracostomy with large bore chest tube can cause significant discomfort of patients. The aim of this study is to evaluate the efficacy of small bore catheter for drainage and administration of sclerosing agent in the treatment of malignant pleural effusions.

METHODS: Sixty patients with malignant pleural effusions were randomly assigned to small bore catheter thoracostomy closed drainage group or conventional pleural aspiration group. Cisplatin and interleukin-2 were infused into the thoracic cavity in eligible patients after drainage. Responses were evaluated 30 days later.

RESULTS: Overall response rate (complete response plus partial response) was 80.00% in small bore catheter thoracostomy closed drainage group and 36.67% in conventional pleural aspiration group respectively (P < 0.01). And the side effects in small bore catheter thoracostomy closed drainage group were obviously less than that in conventional pleural aspiration group.

CONCLUSIONS: Small bore intercostal catheter for drainage and administration of sclerosing agent is a valid and safe option for malignant pleural effusions.