Rapid pleurodesis in symptomatic malignant pleural effusion


Creative Commons License

Yildirim E., Dural K., Yazkan R., ZENGİN N. , Yildirim D., Gunal N., ...More

European Journal of Cardio-thoracic Surgery, vol.27, no.1, pp.19-22, 2005 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Abstract
  • Volume: 27 Issue: 1
  • Publication Date: 2005
  • Doi Number: 10.1016/j.ejcts.2004.08.034
  • Title of Journal : European Journal of Cardio-thoracic Surgery
  • Page Numbers: pp.19-22
  • Keywords: pleural diseases, pleurisies, malignant pleural effusion, pleurodesis, methods, efficacy, treatment, MANAGEMENT

Abstract

Objective: The objective of the study was to see whether a rapid method of pleurodesis was superior to the standard protocol in patients with symptomatic malignant pleural effusion. Methods: Between January 2000 and February 2003, a prospective randomised trial was carried out in a sequential sample of 27 patients with malignant pleural effusions documented cytopathologically. Twelve patients were allocated to group 1 (standard protocol) and 15 to group 2 (new protocol). A small-bore catheter (12 Fr) and oxytetracycline (35 mg/kg of body weight) were used in both groups. In group 1, patients had drainage until radiological evidence of lung re-expansion was obtained and the amount of fluid drained was less than 150 ml/day, before oxytetracycline was instilled. The catheter was removed when the amount of fluid drained after instillation was less than 150 ml/day. In group 2, patients had the oxytetracycline instilled in a fractionated-dose manner following frequent aspirations at 6 h intervals. The catheter was removed when the total amount of fluid drained after instillation of the oxytetracycline [OT] was less than 150 ml/last three aspirations. Response was evaluated at 1, 3 and 6 months after pleurodesis. Results: There was no statistically significant difference in the demographic features, site of the primary tumour, disease characteristics, and response rates in any evaluation period in both groups (P>0.05). However, the number of days of drainage and hospitalisation, and the cost were significantly lower in the second group (P<0.001). Conclusions: This new pleurodesis method provided shorter hospital stay resulting in superior cost-effectiveness and palliation without sacrificing the efficacy of pleurodesis. © 2004 Elsevier B.V. All rights reserved.