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Eur J Cardiothorac Surg 2005;27:19-22
© 2005 Elsevier Science NL

Rapid pleurodesis in symptomatic malignant pleural effusion

^a Department of Thoracic Surgery, Ankara Numune Education and Research Hospital, Ankara, Turkey
^b Department of Medical Oncology, Ankara Numune Education and Research Hospital, Ankara, Turkey

Received 30 June 2004; received in revised form 5 August 2004; accepted 17 August 2004.

^* Corresponding author. Asagiövecler Mh. 79.Sk. 8/3 06460 Dikmen-Cankaya, Ankara, Turkey. Tel.: +90 312 482 72 79; fax: +90 312 310 34 60. (E-mail: erseyda{at}yahoo.com).

Objective: The objective of the study was to see whether a rapid method of pleurodesis was superior to the standard protocol in patients with symptomatic malignant pleural effusion. Methods: Between January 2000 and February 2003, a prospective randomised trial was carried out in a sequential sample of 27 patients with malignant pleural effusions documented cytopathologically. Twelve patients were allocated to group 1 (standard protocol) and 15 to group 2 (new protocol). A small-bore catheter (12Fr) and oxytetracycline (35mg/kg of body weight) were used in both groups. In group 1, patients had drainage until radiological evidence of lung re-expansion was obtained and the amount of fluid drained was less than 150ml/day, before oxytetracycline was instilled. The catheter was removed when the amount of fluid drained after instillation was less than 150ml/day. In group 2, patients had the oxytetracycline instilled in a fractionated-dose manner following frequent aspirations at 6h intervals. The catheter was removed when the total amount of fluid drained after instillation of the oxytetracycline [OT] was less than 150ml/last three aspirations. Response was evaluated at 1, 3 and 6 months after pleurodesis. Results: There was no statistically significant difference in the demographic features, site of the primary tumour, disease characteristics, and response rates in any evaluation period in both groups (P>0.05). However, the number of days of drainage and hospitalisation, and the cost were significantly lower in the second group (P<0.001). Conclusions: This new pleurodesis method provided shorter hospital stay resulting in superior cost-effectiveness and palliation without sacrificing the efficacy of pleurodesis.

Key Words: Pleural diseases • Pleurisies • Malignant pleural effusion • Pleurodesis • Methods • Efficacy • Treatment