الفهرس 
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Abstract
Background: Malignant pleural effusions can produce significant respiratory symptoms and diminished quality of life in patients with terminal malignancies, palliation of respiratory symptomscan be performed via several different approaches but a minimally invasive procedure to control malignant pleural effusions and to provide relief ofrespiratory symptoms would be optimal. Objective: This study aim to evaluate the usage of a small bore catheter in outpatientas an alternative, effective and safe method to the traditionally large bore chest tubein the management of malignant pleural effusion and to assessthe effectiveness of indwelling pleural catheter in patients with malignant pleural effusions with failed pleurodesis and trapped lung. Patients and Methods: sixty five patients with malignant pleural effusion were randomly grouped into three groups according to the method of drainage.Results:results concluded that there were significant statistical difference in the results of both groups of chest tube and pleural catheter regarding tube and catheter duration as the duration of catheter which was 4 (3 – 5) days to 11 (10 –10.25) days in chest tube group and cost of hospital stay and maneuver and total cost as the cost of hospital and medication was 780 ± 1400 L.E in the pleural catheter group while in chest tube group was 11520 ± 1895.61L.E and the total cost was 5520 ± 17600 in pleural catheter group and 14020.00 ± 1895.61 L.E in chest tube group. and modified Borg scale for dyspnea modified Borg scale for dyspnea after insertion with 43 % improvement in dyspnea in pleural catheter group to 41% in chest tube group after insertion of tube or catheter and spontaneous pleurodesis occurred with 46.7 % in the group with indwelling pleural catheter and its predictors were the catheter duration and modified Borg scale for dyspnea before insertion complications were26.7% blocked catheter , 13.3% pain ,6.7% for each of cellutis and empyma and dislodged catheter. Conclusion: from the results of this study and other studies performed by others, we conclude that small-bore catheter is as effective, safe as large bore chest tube in the treatment of malignant pleural effusions and the use of the indwelling pleural catheter in the outpatient clinichad few complications andthe costs associated with hospitalization was decreased andimportantlymost of the patients are allowed to remain in the comfort of their home with family and friends without compromising comfort and symptom control.