ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Rapid pleurodesis in malignant pleural effusion: a clinical study and literature review
Rasih Yazkan1, Erkan Yıldırım2, Koray Dural3, Nurullah Zengin4, Ünal Sakıncı3
1Şanlıurfa Eğitim ve Araştırma Hastanesi, Göğüs Cerrahisi Kliniği, Şanlıurfa
2Medical Park Göztepe Hastanesi, Göğüs Cerrahisi Bölümü, İstanbul
3Ankara Numune Eğitim ve Araştırma Hastanesi, Göğüs Cerrahisi Kliniği, Ankara
4Ankara Numune Eğitim ve Araştırma Hastanesi, Tıbbi Onkoloji Kliniği, Ankara
DOI : 10.5606/tgkdc.dergisi.2011.053
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: 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.

Keywords : Malignant pleural effusion; pleural disease; pleurodesis; treatment
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