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: Thirty-six patients with cytopathologically confirmed
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.