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.