Does a posteriorly or interlobularly positioned chest tube really affect the success rate of pleurodesis?

Malignant pleural effusion is a common problem observed in patients with cancer which reduces their quality of life. Some experts suggest that the chest tube should be directed posteriorly toward the diaphragm during pleurodesis. However, it is unclear whether a posteriorly positioned chest tube is really better than an interlobularly or anteriorly positioned chest tube. We performed a retrospective chart review of patients undergoing pleurodesis between April 2011 and September 2016. A total of 86 patients were enrolled and divided into three groups based on the chest tube position: posterior (group 1), interlobular (group 2), and anterior (group 3). The primary endpoint was the success rate of pleurodesis (complete or partial), and the secondary endpoint was the complication rate (pain and fever). A value of p <0.05 was considered to be significant. Statistical Analysis was performed by EZR (version 1.33). In total, 66, 12, and 8 patients were included in groups 1, 2, 3, respectively. Complete and partial success was obtained in 57 (86.4 %), 10 (83.3 %), and 5 (62.5 %) patients in groups 1, 2, and 3, respectively. Success rates were similar in all groups (p = 0.225). Complications were observed in 51 (77.3 %), 8 (66.7 %), and 8 (100 %) patients in groups 1, 2, and 3, respectively (p = 0.2055). There was no statistically significant difference regarding age, sex and medication. In malignant pleural effusion, the success rates of pleurodesis may be similar regardless of the position of the tube inserted. However, this is a retrospective study and participants are insufficient. Further investigation is required.