Matus Ismael, Ho Patrick
Thoracic Surgery and Interventional Pulmonology Service, Helen F. Graham Cancer Center and Research Institute.
Department of Medicine, Christiana Care Health System, Newark, DE.
J Bronchology Interv Pulmonol. 2019 Oct;26(4):290-292. doi: 10.1097/LBR.0000000000000599.
Malignant pleural effusions' (MPEs) treatment goals focus on optimizing the quality of life and decreasing time spent in health care facilities in this patient population with limited life expectancy. Numerous pleural palliation options and combination of these exist and continue to undergo studies to identify safe, superior and ideally patient-centered care. We report a cohort of 13 patients with symptomatic MPE managed with iodopovidone intrapleural instillation via an indwelling pleural catheter (IPC) in the ambulatory setting. Successful complete pleurodesis was achieved in 10 of 13 (76.9%) patients at a median time of 5 days with IPC removal at a median of 16 days. Two patient obtained partial pleurodesis with IPC removal, 1 required IPC reinsertion due to symptom recurrence. Complications were limited to intraprocedural pain in 4 patients (31%). Iodopovidone pleurodesis via IPC may represent a safe, feasible, and effective ambulatory-based option for pleural palliation in MPE.
恶性胸腔积液（MPEs）的治疗目标侧重于改善这类预期寿命有限患者的生活质量，并减少其在医疗机构的停留时间。目前有多种胸膜减状治疗方案及其组合，并且这些方案仍在不断进行研究，以确定安全、更优且理想的以患者为中心的治疗方法。我们报告了一组13例有症状的MPE患者，在门诊环境中通过留置胸膜导管（IPC）进行碘普罗胺胸腔内灌注治疗。13例患者中有10例（76.9%）成功实现完全胸膜固定术，中位时间为5天，IPC移除的中位时间为16天。2例患者实现部分胸膜固定术并移除IPC，1例因症状复发需要重新插入IPC。并发症仅限于4例患者（31%）出现术中疼痛。通过IPC进行碘普罗胺胸膜固定术可能是一种安全、可行且有效的基于门诊的MPE胸膜减状治疗选择。
