Rapid pleurodesis in malignant pleural effusion: A clinical study and literature review Malign plevra efüzyonunda hızlı plörodez: Klinik çalışma ve literatür derlemesi


Yazkan R., Yildirim E., Dural K., ZENGİN N. , Sakinci Ü.

Turkish Journal of Thoracic and Cardiovascular Surgery, vol.19, no.3, pp.410-416, 2011 (Journal Indexed in SCI) identifier identifier

  • Publication Type: Article / Review
  • Volume: 19 Issue: 3
  • Publication Date: 2011
  • Doi Number: 10.5606/tgkdc.dergisi.2011.053
  • Title of Journal : Turkish Journal of Thoracic and Cardiovascular Surgery
  • Page Numbers: pp.410-416
  • Keywords: Malignant pleural effusion, pleural disease, pleurodesis, treatment, TALC PLEURODESIS, SMALL-BORE, MANAGEMENT, TETRACYCLINE, THORACOSTOMY, CATHETER, POUDRAGE

Abstract

Background: In this study, the superiority of the proposed rapid pleurodesis method to the standard pleurodesis method in patients with symptomatic malignant pleural effusion was shown, and the malignant pleural effusion and treatment principles were discussed. Methods: T hirty-six p atients with c ytopathologically c onfirmed malignant pleural effusion were randomly chosen and prospectively evaluated. Sixteen patients were randomly assigned to group 1 (standard pleurodesis) and 20 patients to group 2 (rapid pleurodesis). A small-bore catheter (12F) was inserted in both groups, and oxytetracycline was administered at a dose of 35 mg/kg. In group 1 patients, after the insertion of a pleurocan drainage system, the drain was left to spontaneous drainage until the lung was fully re-expanded. After achieving a daily drainage of <150 mL, oxytetracycline was instilled through the drainage system at a dose of 35 mg/kg. The drain was kept closed for six hours. Afterwards it was left to spontaneous drainage, and the drain was removed upon achieving a daily drainge lower than 150 mL. In group 2, oxytetracycline was administered at fractionated doses, and the drain was removed upon achieving a total drainage of 150 mL during the last three aspirations. Response to treatment was evaluated 1, 3, and 6 months after pleurodesis. Results: There was no statistically significant difference in demographic features, origin of the primary tumor, follow-up period, mortality rate, surgery, chemotherapy and radiotherapy properties, chest radiography findings, size of pleural effusion, or 1st, 3rd and 6th month treatment response rates in either groups (p>0.05). On the other hand, regarding days of drainage and hospitalization along with the cost, significantly lower results were achieved in group 2 (p<0.001). Conclusion: This new rapid pleurodesis method can be safely used in patients with symptomatic malignant pleural effusion due to its short duration of drainage and hospital stay combined with lower cost.