Pleuroperitoneal shunt insertion for super-aged elderly patients with intractable pleural effusion

Abstract

Thoracentesis and pleurodesis are selected for difficult-to-control intractable pleural effusion, but complications associated with puncture and adverse events in pleurodesis may be fatal in patients with poor PS and elderly individuals. Therefore, it is often difficult to carry out in actual clinical practice.

We herein report three 90-year-old patients with refractory pleural effusion who were successfully treated by pleuroperitoneal shunt insertion using a Denver shunt. The cause was unknown in 2 patients and malignant pleural effusion in 1. All patients underwent shunt insertion under general anesthesia. There were no complications associated with surgery, and pleural effusion symptoms were well-controlled in the outpatient clinic thereafter.

Pleuroperitoneal shunt insertion may be a very effective palliative treatment option to improve the QOL of patients with refractory pleural effusion by freeing the patient from symptoms of respiratory distress and frequent thoracentesis procedures. In addition, it will reduce the labor of caregivers, including family members. We consider that the benefits will be marked for both patients and caregivers.