Minimally invasive management of chronic pleural empyema in non-expandable lung: a systematic review of tunneled pleural catheter use as a surgical alternative - Summary - MDSpire
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Minimally invasive management of chronic pleural empyema in non-expandable lung: a systematic review of tunneled pleural catheter use as a surgical alternative
To evaluate the efficacy and safety of tunneled pleural catheters (TPCs) in managing chronic pleural infections in patients with non-expandable lungs, particularly those considered high-risk for surgery.
Key Findings:
TPCs showed infection control in the majority of cases, with complete or partial resolution rates reported up to 100% in selected cohorts.
The infection rate associated with TPCs was 4.9%, with an infection-related mortality of 0.29%.
Post-infection pleurodesis occurred in over 60% of patients.
Effective symptom relief and radiological improvement were reported over follow-up periods ranging from weeks to months.
Intrapleural fibrinolytics were safely administered via TPCs in selected cases.
Interpretation:
TPCs are a feasible and potentially effective management option for selected patients with chronic pleural infections and non-expandable lungs, facilitating ambulatory care and reducing hospitalization, provided careful patient selection is undertaken.
Limitations:
Limited and predominantly observational nature of available evidence.
Need for further prospective studies to define the role of TPCs alongside other minimally invasive strategies, such as video-assisted thoracoscopic surgery.
Conclusion:
TPCs should be considered as part of an individualized, multidisciplinary treatment approach for inoperable pleural empyema.
