In the management of a malignant pleural effusion causing breathlessness, which procedure provides BOTH immediate symptom relief AND reduces the need for repeat thoracentesis?

• A Therapeutic thoracentesis alone
• B Chemical pleurodesis with talc via chest drain
• C VATS pleurectomy
• D Indwelling pleural catheter (IPC) placement ✓

Explanation

The TIME2 and AMPLE trials demonstrated that indwelling pleural catheters (IPC, e.g., Rocket or PleurX) provide equivalent symptomatic relief to talc pleurodesis with fewer inpatient days, and enable outpatient drainage, avoiding repeated thoracentesis. IPCs are preferred in patients with trapped lung (inability to achieve pleurodesis) or those with poor performance status. VATS pleurectomy is invasive and reserved for selected cases. Talc pleurodesis is an alternative but requires hospitalisation and successful full lung expansion.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.