scholarly journals Chemical Pleurodesis for Malignant Pleural Effusion: How Far Have We Come in 80 Years?

Respiration ◽  
2015 ◽  
Vol 90 (5) ◽  
pp. 355-356 ◽  
Author(s):  
Coenraad F.N. Koegelenberg ◽  
Morn� J. Vorster
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Chemical Pleurodesis

scholarly journals Chemical pleurodesis for malignant pleural effusion: which agent is perfect?

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Mohamed Elshabrawy Saleh ◽  
Gehad Awad ◽  
Mohammed Sanad
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Chemical Pleurodesis

scholarly journals Experience of lodopovidone Pleurodesis at A Tertiary Care Hospital in Peshawar

1969 ◽  
Vol 11 (3) ◽  
pp. 123-127
Author(s):  
Muhammad Umar ◽  
Zia Ul Haq ◽  
Imtiaz Khan ◽  
Anila Basit ◽  
Amin Ul Haq ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Efficacy And Safety ◽  
Chemical Pleurodesis ◽  
Effective Agent ◽  
Age Range ◽  
Recurrent Pleural Effusion

Background: Chemical pleurodesis is used for the management of malignant /recurrent pleural effusion and pneumothorax.Malignant pleural effusion is diagnosed on histopathology or malignant cells in pleural fluid. Pneumothorax is diagnosed by chestradiograph. Pleurodesis can be performed surgically or by using medical agents. Various pleurodesis agents have been used e.g.Tetracycline.Bleomycin. Talc and lodopovidone with different success and complications rates.Objective: This study was conducted to know the efficacy and safety of lodopovidone as pleurodesis agent in themanagement of pleural effusion (malignant/recurrent) and recurrent pneumothorax.Material and Methods: This was a descriptive study conducted at department of Pulmonology Lady Reading HospitalPeshawar from February 2018 to May 2019.Results:A Total of 213 patients were included in the study, among which 120 (56.3%) were males and 93 (43.6%) werefemales. Age range was from 20 to 83 years. One hundred and thirty eight patients (74.8%) had malignant pleural effusion and75 (35.2%) had recurrent pneumothorax. The success rate with lodopovidone pleurodesis was 85 % (181) as a whole with afailure rate of 13 %( 28) in pleural effusion and 2 %( 4) in pneumothorax. Chest pain (65.7%) was the most common side effectfollowed by fever (24.4%) and dyspnea (12.2%).No serious side effects were observed in this study.Conclusion: lodopovidone is easily available, safer, cheaper and effective agent for chemical pleurodesis in pneumothorax,malignant/recurrent pleural effusion.Keywords: Pleurodesis, lodopovidone. Malignant, Pleural Effusion, Pneumothorax.

scholarly journals Release of growth factors after mechanical and chemical pleurodesis for treatment of malignant pleural effusion: a randomized control study

2015 ◽  
Vol 49 (4) ◽  
pp. 386-394 ◽  
Author(s):  
Aljaz Hojski ◽  
Maja Leitgeb ◽  
Anton Crnjac
Keyword(s):  
Quality Of Life ◽  
Growth Factors ◽  
Growth Factor ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Malignant Pleural Effusion ◽  
Transforming Growth Factor ◽  
Chemical Pleurodesis ◽  
Thoracic Drainage

Abstract Background. Growth factors are key inducers of fibrosis but can also mediate inflammatory responses resulting in increasing pleural effusion and acute respiratory distress syndrome. The primary aim of the study was to analyse growth factors release after performing chemical and mechanical pleurodesis in the first 48 hours at the patients with malignant pleural effusion. The secondary endpoints were to evaluate the effectiveness of the both pleurodeses, symptoms release and the quality of life of patients after the treatment. Patients and methods. A prospective randomized study included 36 consecutive female patients with breast carcinoma and malignant pleural effusion in an intention-to-treat analysis. We treated 18 patients by means of thoracoscopic mechanical pleurodesis and 18 patients by chemical pleurodesis with talcum applied over a chest tube. We gathered the pleural fluid and serum samples in the following 48 hours under a dedicated protocol and tested them for growth factors levels. A quality of life and visual analogue pain score surveys were also performed. Results. Median measured serum vascular endothelial growth factor (VEGF) level after chemical pleurodesis was 930.68 pg/ml (95% CI: 388.22–4656.65) and after mechanical pleurodesis 808.54 pg/ml. (95% CI: 463.20-1235.13) (p = 0.103). Median pleural levels of transforming growth factor (TGF) β1 were higher after performing mechanical pleurodesis (4814.00 pg/ml [95% CI: 2726.51–7292.94]) when compared to those after performing chemical pleurodesis (1976.50 pg/ml [95% CI: 1659.82–5136.26]) (p = 0.078). We observed similar results for fibroblast growth factor (FGF) β; the serum level was higher after mechanical pleurodesis (30.45 pg/ml [95% CI: 20.40–59.42]), compared to those after chemical pleurodesis (13.39 pg/ml [95% CI: 5.04 – 74.60]) (p = 0.076). Mechanical pleurodesis was equally effective as chemical pleurodesis in terms of hospital stay, pleural effusion re-accumulation, requiring of additional thoracentesis, median overall survival, but, it shortened the mean thoracic drainage duration (p = 0.030) and resulted in a higher symptoms release and in a better quality of life (p = 0.047). Conclusions. We recorded an increase in serum VEGF levels after chemical pleurodesis, however on the contrary, an increase in the pleural fluid level of TGFβ1 and FGFβ] after mechanical pleurodesis with respect to compared group. Although the differences did not reach statistical significance, VEGF, TGFβ1 and FGFβ remain the most interesting parameters for future research. Considering the mechanisms of growth factors action, we conclude that in our study group mechanical pleurodesis might be more efficient in terms of growth factors release, thoracic drainage duration and resulted in a higher symptoms release and in a better quality of life than chemical pleurodesis.

Malignant Pleural Effusion: Prognostic Factors for Survival and Response to Chemical Pleurodesis in a Series of 120 Cases

Respiration ◽  
1998 ◽  
Vol 65 (2) ◽  
pp. 108-113 ◽  
Author(s):  
Eva Martínez-Moragón ◽  
Jorge Aparicio ◽  
José Sanchis ◽  
Rosario Menéndez ◽  
M. Cruz Rogado ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
Chemical Pleurodesis

scholarly journals Viscum pleurodesis is as effective as talc pleurodesis and tends to have less adverse effect

2020 ◽  
Vol 28 (11) ◽  
pp. 5463-5467 ◽  
Author(s):  
YongJin Chang ◽  
DeogGon Cho ◽  
KyuDo Cho ◽  
MinSeop Cho
Keyword(s):  
Pleural Effusion ◽  
Adverse Effects ◽  
Malignant Pleural Effusion ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Chemical Pleurodesis ◽  
Talc Pleurodesis ◽  
Reactive Protein ◽  
Cell Counts ◽  
White Blood Cell Counts

Abstract Purpose Many patients diagnosed with advanced cancer have malignant pleural effusion that does not respond to chemotherapy or radiation therapy. These patients often have respiratory symptoms, especially dyspnea. In order to relieve these symptoms, various procedures including chemical pleurodesis have been performed. Although talc is the most widely used and effective sclerosing agent, there it has various adverse effects. The objective of this study was to determine whether Viscum (ABNOVA Viscum® Fraxini Injection, manufactured by ABNOVA GmbH, Germany) could be used as an agent to replace talc in clinical practice. Methods Data of 56 patients with malignant pleural effusion who received chemical pleurodesis after tube thoracostomy from January 2003 to December 2017 were retrospectively reviewed to analyze clinical course and response after pleurodesis with each agent. Results After pleurodesis, changes in numeric rating scale (NRS) was 1.4 ± 1.6 in the talc group and 0.5 ± 1.5 in the Viscum group (p = 0.108). Changes in white blood cell counts after pleurodesis were 4154.8 ± 6710.7 in the talc group and 3487.3 ± 6067.7 in the Viscum group (p = 0.702). Changes in C-reactive protein (CRP) were 9.03 ± 6.86 in the talc group and 6.3 ± 7.5 in the Viscum group (p = 0.366). The success rate of pleurodesis was 93.3% in the talc group and 96% in the Viscum group (p = 0.225). Conclusion Viscum pleurodesis showed comparable treatment results with talc pleurodesis while its adverse effects such as chest pain and fever tended to be relatively weak.

scholarly journals Impact of Chemical Pleurodesis used in the Management of Malignant Pleural Effusion at King Abdulaziz University Hospital, Jeddah, Saudi Arabia

2013 ◽  
Vol 3 (1) ◽  
pp. 17-22
Author(s):  
Ahmed A. Aljohaney
Keyword(s):  
Saudi Arabia ◽  
Pleural Effusion ◽  
Malignant Pleural Effusion ◽  
University Hospital ◽  
Cancer Type ◽  
Chemical Pleurodesis ◽  
Patient Demographics ◽  
Management Algorithm ◽  
Pertinent Data ◽  
King Abdulaziz University

Background: Chemical pleurodesis is a widely accepted management strategy for preventing re-accumulation of a malignant pleural effusion; intrapleural bleomycin can be used for this purpose. Objective: To review the experience with chemical pleurodesis involving bleomycin at our institution. Design: Retrospective analysis of all patients who received bleomycin for chemical pleurodesis over 6 years (May 2006 to April 2012) at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia. Patient demographics, cancer type, and pertinent data were analyzed. Results: The most common cancer-causing malignant pleural effusion was breast cancer (32% of cases). Bleomycin was effective for pleurodesis induction, with a success rate of 85% at 30 days and 55% at 90 days and only a few adverse effects. Conclusion: At our institution, the efficacy of bleomycin for induction of chemical pleurodesis was similar to published studies. Implementation of a management algorithm is required to further improve outcomes in patients with malignant pleural effusion.

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