Diseases of the pleuraUse of tunneled pleural catheters for outpatient treatment of malignant pleural effusionsStather, David Ryan; Tremblay, AlainAuthor Information University of Calgary, Calgary, Alberta, Canada Correspondence to Dr Alain Tremblay, MDCM, FRCPC, FCCP, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, Canada T2N 4N1 Tel: +1 403 210 3866; fax: +1 403 944 1577; e-mail: [email protected] Current Opinion in Pulmonary Medicine: July 2007 - Volume 13 - Issue 4 - p 328-333 doi: 10.1097/MCP.0b013e328121447d Buy Metrics Abstract Purpose of review Malignant pleural effusion is a common complication in advanced malignancy that causes debilitating symptoms which result in impaired quality of life. The primary therapeutic goal in malignant pleural effusion management is effective palliation of the associated respiratory symptoms. Pleurodesis by chest tube or thoracoscopy is widely accepted as the gold standard treatment, although these treatments are not without problems. Tunneled pleural catheters represent a new safe and effective outpatient treatment option for these patients, with no reported mortality and minimal morbidity. Recent findings Chest tube insertion with talc slurry and thoracoscopy with talc insufflation are effective methods for achieving spontaneous pleurodesis, although associated with significant morbidity and mortality. A growing body of evidence is confirming that long-term palliation of malignant pleural effusion can be achieved by using tunneled pleural catheters in a large proportion of relatively unselected patients on an outpatient basis. Summary The optimal method for palliative management of malignant pleural effusion remains controversial. The high success rates, low complication rates and efficacy in patients with a wide range of performance status support the use of tunneled pleural catheters as a first-line treatment for symptomatic malignant pleural effusion. © 2007 Lippincott Williams & Wilkins, Inc.