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Abstract
Recurrent pleural effusion in patients with advanced cancer is a common problem that causes significant morbidity and can negatively affect patient’s quality of life for their remaining months. The necessity for repeated aspiration the relieve dyspnea both physically and psychologically traumatic to the patient and burden on the physician. Pleurodesis is the optimal therapy for malignant pleural effusions, but the optimal method of pleurodesis and the optimal agent used remain debatable. The optimal agent for pleurodesis should be highly effective, free of significant adverse effects, inexpensive and readily available for the clinician. Forty patients with malignant pleural effusion (MPE) were included in our study. They were divided into two groups.
Group (A) :
Included twenty patients who were subjected to iodopovidone pleurodesis. They included 7 males (35%) and 13 females (65%) with age ranging from 19 years to 70 years with a mean of age 52.1 14.1 years.
Group (B) :
Included twenty patients who were subjected to bleomycin pleurodesis. They included 9 males (45%) and 11 females (55%) with age ranging from 21 years to 67 years with a mean of age 51.7 13.9 years.
Tube thoracostomy was done to allow slow drainage of the effusion, after chest X-ray complete lung expansion, the patients were divided into 2 groups. Group (A) were injected by iodopovidone and group (B) were injected by bleomycin. Follow up of the patients was done by chest x-ray after 3 months. The efficacy and safety were assessed during the follow up of these patients in group (A), no complication is met in 17 patients (85%), in the other 3 patients ; 2 patients (10%) developed low grade fever, 1 patient (5%) developed mild chest pain during injection of iodopovidone. Nineteen patients (95%) showed complete response and one patient (5%) showed no response. In group (B), no complications is met in 15 (75%), in the other 5 patients ; 3 patients (15%) developed low grade fever, 2 patients (5%) developed nausea. Complete response occurred in 13 patients (65%) and 7 patients (35%) showed no response.
It is concluded from this study that iodopovidone has superior hand on bleomyin as ascleroting agent in pleurodesis ; it is more safe, inexpensive, simple injection with greater therapeutic efficacy and lower complication rate.