Chemical Pleurodesis, An Effective Symptomatic Treatment of Maliagnant Pleural Effusion

Abstract

To assess the efficacy of chemical pleurodesis in patients with malignant pleural effusion. The prospective, open labeled interventional study was conducted in the department of medicine, LRH, peshawar in collaboration with the chest unit and the patients were enrolled for six months. the study lasted for 18 months from January 1995 to June 1996. After observing the excluding criteria 20 patients with malignant pleural effusiofn (metastatic or criteria 20 patients with malignant pleural effusion (metastatic or mesothelioma) were enrolled in the study. Tube thoracostomy was performed in all selected patients and after draining the effusion to the maximum; either tetracycline or bleomycine was instilled in the intrapleural space as pleurodesing agent. the selection for either agent was made at random. Twenty patients with almost equal male to female ration and an age range of 35 to 85 (mean age 62) received either tetracycline or bleomycine with equal frequency (10 patients receiving tetracycline and 9 bleomycine). one patient was lost to follow up. Response was seen in all patients complete response in fifteen patients (78.5%) and partial response in four patients (21.5%). There was no failure in either group. All patients tolerated the procedure quite well without any majority complaints. Chemical pleurodesis is an effective and safe palliative procedure in patients with recurrent malignant pleural effusion who are not fit for surgery and that both tetracycline and bleomycine are equally effective.