Pleuroperitoneal shunt for malignant pleural effusions: a one-year experience.

Malignant pleural effusions are often debilitating conditions for the patient with advanced cancer. Traditionally, treatment has been repeated thoracentesis or tube thoracostomy with installation of sclerosing agents. This, however, required the patient to be hospitalized and subjected to the pain and inconveniences of the chest tubes. The drainage also had to be low enough for sclerotherapy to be effective. In 1982, the pleurovenous shunt was modified and the pleuroperitoneal shunt became a feasible alternative to sclerotherapy. We started using the Denver pleuroperitoneal shunt in July 1991. Seventeen shunts were inserted into 13 patients over a 1-year period ending June 30, 1992. All patients were relieved of their dyspnea. The average length of patency was 2.5 months, and fewer than 25% of the shunts clotted. Our favorable experience with the shunt has lead us to recommend the Denver pleuroperitoneal shunt for the treatment of recurrent malignant effusions.