{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T14:37:20Z","timestamp":1790260640765,"version":"4.1.0"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T00:00:00Z","timestamp":1635120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p><jats:bold>Background and Objective:<\/jats:bold> Malignant pleural effusion (MPE) often results in debilitating symptoms. Relief of dyspnoea and improvement in quality of life can be achieved with either talc pleurodesis or insertion of an indwelling tunneled pleural catheter (IPC). The former requires a lengthy hospital stay and the latter is associated with lower pleurodesis rates. In response to limited hospital bed capacity, we developed a pragmatic approach in managing MPE by combining thoracoscopic talc poudrage and insertion of IPC into a single day case procedure. We present data on the safety and efficacy of this approach.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Patients who had undergone the abovementioned procedure between 2017 and 2020 were analyzed. Demographic data, hospital length of stay (LOS), histological diagnosis, rates of pleurodesis success and procedural related complications were collated. Patients were followed-up for 6 months.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Forty-five patients underwent the procedure. Mean age was 68.5 \u00b1 10.4 years and 56% were male. Histological diagnosis was achieved in all cases. 86.7% of patients were discharged on the day of the procedure. Median LOS was 0 (IQR 0\u20130) days. Successful pleurodesis was attained in 77.8% at 6-month follow-up. No procedure related deaths or IPC related infections were recorded.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Ambulatory thoracoscopic poudrage and IPC insertion is a safe and effective option in the management of MPE. All patients received a definitive pleural intervention with 77.8% pleurodesis success at 6-months and majority of them discharged on the same day. Future randomized trials are required to confirm these findings.<\/jats:p>","DOI":"10.3389\/fsurg.2021.738719","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T05:01:45Z","timestamp":1635138105000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":22,"title":["Ambulatory Thoracoscopic Pleurodesis Combined With Indwelling Pleural Catheter in Malignant Pleural Effusion"],"prefix":"10.3389","volume":"8","author":[{"given":"Chuan T.","family":"Foo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Pulimood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Knolle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan J.","family":"Marciniak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurgen","family":"Herre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1093\/ejcts\/ezy258","article-title":"ERS\/EACTS statement on the management of malignant pleural effusions","volume":"55","author":"Bibby","year":"2019","journal-title":"Eur J Cardiothorac Surg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1164\/rccm.201807-1415ST","article-title":"Management of malignant pleural effusions. An official ATS\/STS\/STR clinical practice guideline","volume":"198","author":"Feller-Kopman","year":"2018","journal-title":"Am J Respir Crit Care Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1001\/jama.2019.19997","article-title":"Effect of thoracoscopic talc poudrage vs. talc slurry via chest tube on pleurodesis failure rate among patients with malignant pleural effusions: a randomized clinical trial","volume":"323","author":"Bhatnagar","year":"2020","journal-title":"JAMA."},{"key":"B4","doi-asserted-by":"publisher","first-page":"2383","DOI":"10.1001\/jama.2012.5535","article-title":"Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: the TIME2 randomized controlled trial","volume":"307","author":"Davies","year":"2012","journal-title":"JAMA."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1313","DOI":"10.1056\/NEJMoa1716883","article-title":"Outpatient talc administration by indwelling pleural catheter for malignant effusion","volume":"378","author":"Bhatnagar","year":"2018","journal-title":"N Engl J Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1007\/s11606-010-1472-0","article-title":"Efficacy and safety of tunneled pleural catheters in adults with malignant pleural effusions: a systematic review","volume":"26","author":"Van Meter","year":"2011","journal-title":"J Gen Intern Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1597","DOI":"10.1378\/chest.12-3103","article-title":"Clinical outcomes of indwelling pleural catheter-related pleural infections: an international multicenter study","volume":"144","author":"Fysh","year":"2013","journal-title":"Chest."},{"key":"B8","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1111\/resp.12962","article-title":"Cost-effectiveness of indwelling pleural catheter compared with talc in malignant pleural effusion","volume":"22","author":"Olfert","year":"2017","journal-title":"Respirology."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1050","DOI":"10.1164\/rccm.201607-1404OC","article-title":"Randomized trial of pleural fluid drainage frequency in patients with malignant pleural effusions. The ASAP trial","volume":"195","author":"Wahidi","year":"2017","journal-title":"Am J Respir Crit Care Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.3978\/j.issn.2072-1439.2015.01.51","article-title":"Pleural controversies: indwelling pleural catheter vs. pleurodesis for malignant pleural effusions","volume":"7","author":"Fortin","year":"2015","journal-title":"J Thorac Dis."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1419","DOI":"10.1378\/chest.10-1868","article-title":"Rapid pleurodesis for malignant pleural effusions: a pilot study","volume":"139","author":"Reddy","year":"2011","journal-title":"Chest."},{"key":"B12","doi-asserted-by":"publisher","first-page":"2538","DOI":"10.21037\/jtd.2016.08.55","article-title":"Patient evaluation for rapid pleurodesis of malignant pleural effusions","volume":"8","author":"Krochmal","year":"2016","journal-title":"J Thorac Dis."},{"key":"B13","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1097\/LBR.0000000000000186","article-title":"Pleuroscopic pleurodesis combined with tunneled pleural catheter for management of malignant pleural effusion: a prospective observational study","volume":"22","author":"Boujaoude","year":"2015","journal-title":"J Bronchol Interv Pulmonol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1111\/resp.13937","article-title":"Thoracic ultrasound as a predictor of pleurodesis success at the time of indwelling pleural catheter removal","volume":"26","author":"Chaddha","year":"2021","journal-title":"Respirology."}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2021.738719\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T05:01:47Z","timestamp":1635138107000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2021.738719\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,25]]},"references-count":14,"alternative-id":["10.3389\/fsurg.2021.738719"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2021.738719","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,25]]},"article-number":"738719"}}