Risk Factors Affecting Spontaneous Pleurodesis After Indwelling Tunneled Catheter Application in Malignant Pleural Effusion

Objective: Spontaneous pleurodesis with indwelling tunneled catheter in malignant pleural effusions has a very important role in the improvement of dyspnea and quality of life of patients. Our aim in this study was to determine the efficacy of indwelling tunneled catheterization in malignant pleural effusion and the risk factors affecting the occurrence of spontaneous pleurodesis. Materials and Methods: The study included 34 patients who underwent Indwelling Tunneled Catheter (ITC) for malignant pleural effusion in our thoracic surgery clinic between August 2020 and August 2022. Demographic data of the patients, primary malignancy, pleural procedures performed for malignant pleural effusion, indication for ITC, serum albumin level before ITC, duration of hospitalization, complications related to ITC and post-discharge follow-up were recorded. Results: The underlying primary malignancy of the 34 patients included in the study was metastatic lung cancer in 18 patients, breast cancer in 6 patients, colon cancer in 5 patients, mesothelioma in 3 patients and malignant melonoma in 2 patients. The reason for ITC was entrapped lung in 18 patients, recurrent effusion despite previous drainage and chemical pleurodesis in 11 patients, and high-flow drainage in 5 patients. There was a statistically significant correlation between the absence of an entrapped lung, the short interval between the onset of malignant pleural effusion and the application of ITC, the absence of a history of massive effusion, and the length of time to terminate ITC and the success of spontaneous pleurodesis. Conclusion: ITC is a safe method with few complications for achieving spontaneous pleurodesis in malignant pleural effusions. In the occurrence of spontaneous pleurodesis, the presence of an entrapped lung, the presence of massive effusion, the time between the onset of malignant pleural effusion and the application of ITC, and the duration of termination of ITC are important risk factors.