The Low-Cost, Long-Term Indwelling Pleural Catheter (LunGO): An Inexpensive and Effective Alternative for the Management of Dyspnea Associated with Malignant Pleural Effusions

Background: A malignant pleural effusion (MPE) in patients with cancer is evidence of the underlying disease progression, resulting in many symptoms, and may lead to hospitalization. The treatment options include talc pleurodesis (TP) or the implantation of an indwelling pleural catheter. The costs of the latter approach are often seen to be inhibitive for the Brazilian and other emerging markets’ public health system. Objectives: To assess the feasibility of utilizing a low-cost device (LunGO) through a case-control study. Methods: Eighteen patients with recurrent neoplastic pleural effusion and contraindications to pleurodesis were recruited between June 2016 and November 2017. The patients were submitted to pleural catheter prototype implantation. Data on the underlying disease and hospital length of stay after the procedure were collected and compared with patients who underwent pleurodesis in the same period (control group, n = 34). Results: In the LunGO group, 7 patients died due to the natural evolution of the underlying disease with the drain, whereas it was removed in 11 patients at a median of 43 days. Recurrence requiring an intervention was seen with the LunGO in 2, compared to 5 (OR = 1.37, p = 1) with TP. Complications were observed in only 1 with the LunGO, compared to 5 with TP. The chances of recurrence in both cohorts do not have a statistically significant difference, with an OR = 1.08 (p = 0.93). There was a tendency towards lower mortality in the LunGO cohort, despite that fact that we did not observe statistical significance (OR = 0.16, p = 0.23). Conclusion: LunGO was shown to be a viable and safe device for the treatment of symptomatic MPE.