Efficacy of drainage of pleural effusion using small bore pleural catheter and conventional thoracostomy using large bore chest tube: a comparative study

Easwaramangalath Venugopal Krishnakumar, Muhammed Anas, Davis Kizhakkepeedika Rennis, Vadakken Devassy Thomas, Babu Vinod


Background: Pleural effusions commonly occur in patients with advanced cancer and tuberculosis. Pleural aspiration by the conventional tube thoracostomy using large bore chest tube-intercostal drain (ICD) - can often cause discomfort to patients. The aim of this study is to compare the efficacy of drainage of pleural effusions using flexible small bore Pleural Catheter (PC) and ICD.  

Methods: In this prospective study, 101 patients (age 16-65 years) with pleural effusions were divided into PC (n=60) and ICD (n=41) groups. Responses were evaluated and analyzed statistically.

Results: The PC group was equally efficacious as ICD with regard to complete re-expansion of lung. The most common complication in the PC group was block (9/60 i.e. 15%). Difference in the mean number of days on drain in the PC (4.9 days) and ICD group (5.8 days) as well as the mean number of times analgesics administered in the PC (2.85 days) and the ICD group (7.53 days) were statistically significant (p <0.05). Similarly, the complications such as surgical emphysema, haemorrhage, desaturation and hypotension were high in the conventional group when compared to that of PC group (p <0.05).

Conclusions: Flexible small bore intercostal catheter is a valid and safe option for drainage of pleural effusion when compared to the conventional tube thoracostomy.



Pleural effusions, Thoracostomy, Tuberculosis, Pleural catheterization, Dyspnoea, Hemothorax, Desaturation, Emphysema

Full Text:



Aziz F, Penupolu S, Flores D. Efficacy of percutaneous pigtail catheters for thoracostomy at bedside. J Thorac Dis. 2012;4:292-5.

Seldinger SI. Catheter replacement of the needle in percutaneous arteriography: a new technique. Acta Radiol. 1953;39:368-76.

Laws D, Neville E, Duffy J. BTS guidelines for the insertion of a chest drain. Thorax. 2003;58(Suppl 2):ii53-9.

Lin CH, Lin WC, Chang JS. Comparison of pigtail catheter to chest tube for drainage of parapneumonic effusion in children. Pediatr Neonatol. 2011;52:337-41.

Gammie JS, Banks MC, Fuhrman CR, Pham SM, Griffith BR, Keenan RJ, et al. The pigtail catheter for pleural drainage: a less invasive alternative to tube thoracostomy. JSLS. 1999;3:57-61.

Lambert R, Gurgacz S. The Pleurx® catheter for malignant pleural effusion: Australian Safety and Efficacy Register for New Interventional Procedures - Surgical (ASERNIP-S). State of Queensland (Queensland Health), 2012. Available at:

Akçay S, Boyvat F, Çelik N, Karacan Ö, Füsun Öner Eyübo¤lu. A comparative study of two small bore pleural drainage systems. Turkish Respir J. 2003;4:70-5.

Sudharshan S, Ferraris VA, Mullett T, Ramaiah C. Effectiveness of tunnelled pleural catheter placement in patients with malignant pleural effusions. Int J Angiol. 2011;20:39-42.

Putnam JB Jr, Light RW, Rodriguez RM, Ponn R, Olak J, Pollak JS, et al. A randomized comparison of indwelling pleural catheter and doxycycline pleurodesis in the management of malignant pleural effusions. Cancer. 1999;86:1992-9.

Fysh ET, Waterer GW, Kendall PA, Bremner PR, Dina S, Geelhoed E, et al. Indwelling pleural catheters reduce inpatient days over pleurodesis for malignant pleural effusion. Chest. 2012;142:394-400.

Jain S, Deoskar RB, Barthwal MS, Rajan KE. Study of pigtail catheters for tube thoracostomy. MJAFI. 2006;62:40-1.

Bediwy1 AS, Amer HG. Pigtail catheter use for draining pleural effusions of various etiologies. ISRN Pulmonol. 2012;2012:143295.