Indwelling Pleural and Abdominal Catheters (PleurX) for Management of Pleural Effusions and Ascites: A Single Centre’s 10 Year Experience

Abstract

Background: Recurrent pleural effusions and abdominal ascites are seen in both malignant and non-malignant diseases, and can cause significant disease burden. Indwelling catheters for malignant pleural effusions are part of current accepted practice. Indwelling peritoneal catheters for malignant ascites have yet to be recommended by any society guideline. We aimed to evaluate outcomes in our patients who have had indwelling pleural and peritoneal catheters placed for malignant and non-malignant pleural effusions and abdominal ascites. Method: A retrospective cohort study of patients who had indwelling pleural and peritoneal catheters inserted over a 10 year period from 2011 to 2020 was carried out. Inclusion criteria consisted of all patients who had either a pleural or peritoneal indwelling catheter placed for any indication. We evaluated catheter-related complications. Results: There were 193 discrete indwelling pleural catheters for malignant pleural effusions, with a median dwell time of 41 days. The infection rate in these were 6.2%, and 12.4% of catheters had complications of blockage or dislodgement. There were 2 catheters inserted for parapneumonic effusions, further analysis was limited given the low number. There were 121 discrete indwelling peritoneal catheters for malignant abdominal ascites, with a median dwell time of 31 days. The rate of infection was 5.8%, and another 5.8% of catheters became blocked or dislodged. An additional 6 peritoneal catheters were inserted for non-malignant abdominal ascites, with a median dwell time of 28 days. Two cases of infection were found in this group. Conclusion: This is to our knowledge one of the larger patient cohorts in studies relating to indwelling peritoneal catheters for malignant abdominal ascites. Our data shows that indwelling peritoneal catheters have low complication rates on par with pleural catheters which are current accepted practice. The usage of indwelling pleural and peritoneal catheters may be considered for the management of refractory pleural effusions and abdominal ascites.