Abstract Introduction: Recurrent pleural effusions (RPEs) significantly impair the quality of life and remain a therapeutic challenge. Video-assisted thoracoscopic surgery (VATS) pleurodesis is an established treatment, while the role of primary indwelling pleural catheter (IPC) implantation during surgery is not yet clearly defined. This study compared the outcomes of thoracoscopic treatment of RPEs with and without primary IPC implantation. Patients and Methods: In this retrospective bicentric study, 115 adult patients undergoing VATS for RPEs between January 2022 and December 2023 were analysed. Patients were treated at either Knappschaft Kliniken Lünen (KKL), where VATS pleurodesis without IPC was standard, or Helios University Hospital Wuppertal (WUP), where routine primary IPC implantation was performed. Demographic data, operative characteristics, post-operative chest drainage duration and length of hospital stay (LOS) were evaluated. Statistical analysis was performed using unpaired t -tests. Results: Operative duration did not differ significantly between groups. However, patients in the WUP group demonstrated a significantly shorter duration of post-operative chest drainage (3.4 ± 1.5 vs. 5.2 ± 2.1 days) and reduced LOS (5.8 ± 1.6 vs. 7.4 ± 2.4 days) compared with the KKL group. Post-operative complications were minor and comparable between groups, with no major complications observed. Conclusion: Simultaneous IPC implantation during VATS pleurodesis for RPEs is associated with shorter chest drainage duration and hospital stay without increasing operative time or morbidity. This combined approach represents a safe and effective treatment option for selected patients. Prospective studies are warranted to confirm long-term benefits.
Redwan et al. (Fri,) studied this question.