Comparative outcomes of indwelling pleural catheter versus chemical pleurodesis in malignant pleural effusion management: a systematic review and meta-analysis
Main Article Content
Keywords
Indwelling pleural catheter, malignant pleural effusion, meta-analysis, pleurodesis
Abstract
Introduction: Patients with advanced cancers frequently get malignant pleural effusions (MPEs). Chemical pleurodesis (CP) and the placement of an indwelling pleural catheter (IPC) are the two main therapy approaches. IPC installation in the outpatient context has grown in popularity. There is ongoing discussion over their relative efficacy. This study aimed to evaluate the comparison of outcomes of indwelling pleural catheter versus chemical pleurodesis in malignant pleural effusion management.
Methods: A thorough literature search was carried out using the databases of the Cochrane Library, PubMed, Google Scholar, Medline, Embase, and BMJ. Among these were six controlled trials. Random and fixed effects model is used with Review Manager. Continuous outcomes were measured using mean & SD differences, whereas dichotomous outcomes were measured using odds ratios (OR) with 95% CI.
Results: Significantly the IPC group has fewer further pleural procedures than CP group with OR 0.25 (95% CI: 0.15-0.43; p≤0.00001), despite its higher event of pleural infection OR 2.47 (95% CI: 1.07-5.67; p=0.03). The improvement in dyspnea score -0.65 (95% CI: -10.54-9.24; p=0.9), quality of life 1.35 (95% CI: -0.03–2.73 p=0.05), and number of hospital stay 0.23 (95% CI: -1.67-2.13; p=0.81) showed no significant differences between groups.
Conclusion: This study along with previous others, concerning other variable outcomes, may still highlights for personalized treatment considering patient preferences and clinician considerations in managing malignant pleural effusions. This study also showed that IPC may reduce repeat pleural procedures despite its tolerable pleural infection related problems.
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