Radiology Department, Medical Faculty, Bulent Ecevit University, İbni Sina Kampüsü, 67600, Esenköy-Kozlu, Zonguldak, Turkey.
Radiology Department, Medical Faculty, Biruni University Hospital, Beşyol Mahallesi Eski Londra Asfaltı No: 10 Küçükçekmece, Istanbul, Turkey.
Cardiovasc Intervent Radiol. 2022 Nov;45(11):1735-1741. doi: 10.1007/s00270-022-03248-2. Epub 2022 Aug 9.
No evidence exists to support the use of tunneled non-cuffed pigtail drainage catheters in patients with refractory ascites or pleural effusion. The purpose of this study was to determine the feasibility of non-cuffed tunneled pigtail drainage catheters in patients with refractory ascites or pleural effusions.
Between October 5, 2020 and May 25, 2021, 34 pigtail catheters were implanted in 27 patients (17 males, 10 females; average age: 65.66 ± 12.04 years) under either ultrasound or computed-tomography guidance (19 catheters for ascites, 15 catheters for pleural effusion). Twenty-eight catheters (82.35%) were implanted for malignant etiologies, and 6 catheters (17.65%) were implanted for benign etiologies. The catheters (size: 8-14 French) were implanted through a subcutaneous tunnel. Complication rate and factors related to complications were analyzed. Catheter lifetime was analyzed with Kaplan-Meier method.
Patency ranged from 3 to 211 days. None of the patients experienced a major complication (e.g., peritonitis and empyema). Meanwhile, 8 minor complications were observed including 3 catheter occlusion, 3 ascites leakage, 1 peri-catheter local skin infection, 1 peri-catheter local skin reaction. None of the etiologies were related to the catheter complications. However, the 8-F catheter was associated with a significantly higher complication rate (odds = 5.5, p = 0.044). The estimated mean [CI] dwelling time of a catheter was 59.18 [32.97, 85.39] days.
Image-guided insertion of tunneled peritoneal or pleural pigtail external drainage catheters achieved with a 100% technical success rate and resulted in an acceptable complication rate and catheter lifetime for the management of refractory ascites or pleural effusion.
没有证据支持在难治性腹水或胸腔积液患者中使用带隧道无袖套猪尾引流导管。本研究的目的是确定无袖套隧道猪尾引流导管在难治性腹水或胸腔积液患者中的可行性。
在 2020 年 10 月 5 日至 2021 年 5 月 25 日期间，在超声或计算机断层扫描引导下，将 34 根猪尾导管植入 27 名患者（17 名男性，10 名女性；平均年龄：65.66±12.04 岁）中，其中 19 根用于腹水，15 根用于胸腔积液。28 根导管（82.35%）植入的病因是恶性的，6 根导管（17.65%）植入的病因是良性的。导管（大小：8-14 法国）通过皮下隧道植入。分析并发症发生率和与并发症相关的因素。用 Kaplan-Meier 法分析导管的使用寿命。
通畅时间为 3 至 211 天。所有患者均未发生严重并发症（如腹膜炎和脓胸）。同时，观察到 8 例轻微并发症，包括 3 例导管堵塞、3 例腹水渗漏、1 例导管周围局部皮肤感染、1 例导管周围局部皮肤反应。病因与导管并发症无关。然而，8-F 导管的并发症发生率明显更高（优势比=5.5，p=0.044）。导管留置的估计平均[CI]时间为 59.18[32.97,85.39]天。
经影像引导植入隧道式腹膜或胸膜猪尾外引流导管，技术成功率达 100%，并发症发生率和导管留置时间可接受，可用于治疗难治性腹水或胸腔积液。
