Study Of Intercostal Tube Drainage Versus Pigtail Drainage For Management Of Malignant Pleural Effusion

Abstract

Background: Malignant pleural effusion (MPE) is common in advanced cancer disease. Treatment
consists of sequential thoracentesis or tube thoracostomy but the use of pigtail catheters have become
increasingly common.
Aim : To compare intercostal tube drainage and pigtail drainage regarding pain score, duration of hospital
stay, duration of drainage and the success rate of pleurodesis in patients with malignant pleural effusion .
Methods: A prospective study was conducted in chest department, Kasr El-Aini hospital, Cairo University
in the period from June 2018 to January 2020. It included 40 patients with MPE were classified into Group
A: 20 patients underwent thoracoscopic pleural biopsy with intercostal tube insertion. Group B: 20 patients
underwent US guided biopsy with pigtail insertion. The pain score assessed during the procedures using
visual analogue scale VAS. Duration of hospital stay and duration of drainage were recorded. pleurodesis
was done by Doxycycline (vibramycin) .
Results: Both groups were similar regarding success rate of pleurodesis .Pigtail catheters were associated
with minor complications. Regarding chest pain using VAS group B (VAS 1.7 ± 1.34) was lesser than
group A (VAS 7.3 ± 0.98), duration of hospitalization and duration of drainage was shorter in group B
(6.55 ± 1.23 days) and (3.95 ± 0.83 days) respectively .
Conclusion: Small bore catheter is a good alternative to chest tube for drainage of MPE as it’s equally
effective and significantly less painful. Moreover, pigtail catheter drainage reduces the length of hospital
stay .