Fully implantable subcutaneous pleural port for patient-centered management of recurrent non-malignant pleural effusions

Background: Non-malignant pleural effusions (NMPEs) significantly impact patients’ quality of life and represent a growing healthcare burden. We describe an alternative, patient-centered approach for managing recurrent NMPEs: the subcutaneous pleural port catheter (SPPC) technique.

Methods: We conducted a retrospective cohort study of patients with NMPEs managed with SPPC between December 2023 and February 2026. Demographic details, clinical presentation, fluid volume management, and patient-tolerability were recorded. The procedure involved placement of a pleural catheter with subcutaneous tunneling, followed by routine outpatient drainage.

Results: Eight patients met the inclusion criteria. Port placement was right-sided in four patients (50%), left-sided in three (37.5%), and bilateral in one (12.5%). The median duration of port use was 204 days [interquartile range (IQR) 129–528 days], with a median of six drainages per patient (IQR 4–20) and a median volume of 790 mL drained per session (IQR 350–1,110 mL). All patients reported a positive overall experience, characterized by symptom relief after drainage and tolerability of port in situ.

Conclusions: SPPC appears to be a safe and feasible outpatient option for selected patients requiring chronic pleural drainage, demonstrating favorable early procedural outcomes and patient tolerability in this study. It may be particularly suitable for patients with low protein, transudative pleural effusions who require intermittent drainage every 2–8 weeks and wish to avoid an external device, irrespective of anticoagulation status. Larger randomized controlled trials are needed to assess long-term efficacy, safety, and patient reported quality of life outcomes, and to define its role in the management of nonmalignant pleural effusions.