Chest
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Randomized Controlled Trial
Pre-EDIT: A randomised feasibility trial of Elastance-Directed Intrapleural catheter or Talc Pleurodesis (EDIT) in Malignant Pleural Effusion.
Talc slurry pleurodesis (TSP) prevents recurrence of symptomatic malignant pleural effusion (MPE) in 71% to 78% patients. Nonexpansile lung (NEL) frequently accounts for TSP failure but is often occult predrainage, impairing selection of patients. NEL is associated with high pleural elastance (PEL), but technical limitations have hampered the development of PEL as a predictive NEL marker. We performed a single-center, randomized, controlled, open-label feasibility trial of EDIT (elastance-directed indwelling pleural catheter or TSP) management, using a novel digital manometer and a new definition of high PEL. ⋯ A phase 3 trial testing the effect of EDIT management on symptomatic MPE recurrence following TSP is feasible.