Pleurodese vs cateteres pleurais de longa permanência na abordagem do derrame pleural neoplásico: uma revisão de literatura

• Autor(a) principal: Pordeus Júnior , Mizael Armando Abrantes
• Data de Publicação: 2020
• Tipo de documento: Trabalho de conclusão de curso
• Idioma: por
• Título da fonte: Repositório do Centro Universitário Braz Cubas
• Texto Completo: https://repositorio.cruzeirodosul.edu.br/handle/123456789/1455
• topic: Derrame pleural maligno; Pleurodese; Cateteres de demora; CNPQ::CIENCIAS DA SAUDE::MEDICINA

Introduction: Neoplastic pleural effusion is one of the main complications in câncer patients, being considered an unfavorable prognostic marker. There is much debate about what would be the preferred method of approaching malignant pleural effusion, with pleurodesis and long-term pleural catheters being the most debated and used modalities in clinical practice, however, without a well-established consensus on which technique is more effective . Objective: The present study aimed to assess whether Pleurodesis is superior to long-term pleural catheters in the approach to neoplastic pleural effusion, making a comparison in terms of improvement of symptoms, costbenefit, complications by the procedure and length of hospital stay. Materials and methods: This was an integrative literature review study, which evaluated publications indexed in the PUBMED and LILACS databases published between the years 2010 to 2020, and which met the selection criteria. Data collection was performed through na adaptation of the instrument proposed by Ursi (2005). The data obtained were analyzed and a descriptive review was carried out on the results of the selected publications, in order to evaluate the two methods in the approach to malignant pleural effusion. Results: With the completion of the literature search, 202 publications were found. After applying the selection criteria, 12 publications remained for the sample and had their information collected for analysis. None of the studies showed, in general, a statistically significant difference in the relief of dyspnea with both methods; 1 publication noted a superiority of IPC’s in the relief of dyspnea in patients with incarcerated lungs. Indwelling pleural catheters were more frequently associated with adverse events, but most of them were of little severity and easily treated. Pleurodesis appears to be more economical for patients with longer survival, whereas delay catheters are more cost-effective in patients with limited survival. Regarding the length of hospital stay, all publications have shown that long-term pleural catheters are associated with less time spent in the hospital when compared to pleurodesis. Conclusion: The bibliographic research has shown that there does not seem to be a general superiority between pleurodesis and indwelling pleural catheters in the approach of malignant pleural effusion, and the therapeutic choice must be individualized to the profile of each patient, analyzing the benefits and risks inherent to each one of the procedures, estimated survival, as well as the choice of the patient and his caregivers.