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Abstract
>Malignant pleural effusion is a common complication of primary and metastatic pleural malignancies. It is usually managed by drainage of pleural fluid and pleurodesis, but there is no consensus as to the best method of pleurodesis. Objectives: to evaluate and compare the effectiveness, side effects, and cost of different chemical pleurodesis agents used in patients with malignant pleural effusion. METHODS; between July2003 and September 2005, 75 patients with malignant pleural effusion underwent chemical pleurodesis in our department. Tube thoracotomy was done for all patients. Tetracycline(500mg) in15 patients, talc slurry (5gm/80ml 0.9%saline)was used in 15 patients, , iodopovidone (20cc of10% solution) in 15 patients, bleomycin(1 iu/kg) in 15 patients and 15 patients underwent tube drainage only with the following Inclusion and exclusion criteria; Inclusion criteria , massive or fast collecting pleural effusion after drainage which requires frequent thoracocentesis (< 3 days),subjective improvement of patient general condition following thoracocentesis,total re expansion of the lung after drainage, life expectancy > 6 months ,pleural fluid PH >7.2.Exclusion criteria:atelectasis due to endobronchial obstruction,empyema (pH< 7.2),prior intrapleural therapy for the previous
two weeks and significant irradiation to the affected hemithorax. RESULTS: tetracycline, talc slurry, iodopovidone and bleomycin resulted in an insignificantly different success rates of 80%, 80%, 66.6%.73.3%, at 30 days respectively and, 66.6%, 73.3%, 60%, 66.6% at 60 days respectively, tube was removed, after an average 7.2 ± 1.4 days for tetracycline, 7 ±0.8 for talc slurry, 7.6 ± 0.9 for iodopovidone and 6.4 ±1.5 for bleomycin (respectively) which was statistically non significant and consequently duration of hospitalization.