
This review highlights the advantages of using indwelling pleural catheters (IPC) for managing malignant pleural effusions based on multiple randomized clinical trials. Pain associated with IPC insertion or drainage can be managed, distinguishing it from tumor-related chest wall pain. IPC-related infections require systemic antibiotics and often intrapleural fibrinolytic/deoxyribonuclease therapy, while catheter removal is usually unnecessary. Symptomatic loculation can be treated with fibrinolytics, although recurrence is possible. Catheter tract metastases are common in mesothelioma patients and can be addressed with radiotherapy without damaging the IPC. Other less common complications include dislodgement, irreversible blockage, and catheter fractures upon removal. The review also discusses recommendations from recent consensus statements/guidelines and includes expert opinions in areas lacking evidence.
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