Efficacy of short term versus long term tube thoracostomy drainage before tetracycline pleurodesis in the treatment of malignant pleural effusions.

Villanueva, Andrew G.; Gray, Andrew; Shahian, David M.; Williamson, Warren A.; Beamis, John F.

doi:10.1136/thx.49.1.23

Cited by 92 publications

(65 citation statements)

References 39 publications

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“…In one study, satisfactory results were obtained by removal of the drain 2 h after pleurodesis [76]. In another study, the drain was removed the morning after the day of pleurodesis [77].…”

Section: Chest Tube Drainage and Pleurodesismentioning

confidence: 99%

Thoracoscopy: general overview and place in the diagnosis and management of pleural effusion

Rodríguez-Panadero

Janssen²,

Astoul³

2006

Eur Respir J

154

111

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“…In one study, satisfactory results were obtained by removal of the drain 2 h after pleurodesis [76]. In another study, the drain was removed the morning after the day of pleurodesis [77].…”

Section: Chest Tube Drainage and Pleurodesismentioning

confidence: 99%

Thoracoscopy: general overview and place in the diagnosis and management of pleural effusion

Rodríguez-Panadero

Janssen²,

Astoul³

2006

Eur Respir J

154

111

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“…The efficacy of chemical pleurodesis rests mainly on the performance of an adequate technique allowing complete drainage of the pleural fluid, a total re-expansion of the underlying lung, and consistent adhesion of both pleural surfaces [7,12,13]. In the present series, a standard procedure was carried out by experienced personnel.…”

Section: Discussionmentioning

confidence: 99%

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

Martínez‐Moragón

Aparicio²,

Sanchis³

et al. 1998

Respiration

125

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Chemical pleurodesis is an effective treatment of malignant pleural effusions, but indications must be individualised to optimise its results. The aim of the present study was to investigate the relationship of various prognostic features with both the response rate to pleurodesis and the probability of patient survival. A non-concurrent cohort study was carried out in which 120 evaluable patients with malignant pleural effusion underwent pleurodesis. Lung (40%), breast (26.6%), and unknown primary site (12.5%) carcinomas were the most frequent neoplasms. Clinical data and pleural fluid parameters were analysed. Median overall survival was 9 months. Pleural fluid glucose (<60 mg/dl), Karnofsky performance status (<70), size of the effusion in chest radiographs (massive effusion), pleural fluid pH (<7.20), presence of concomitant alterations in chest radiographs, and pleural lactic acid dehydrogenase levels (>600 U/l) showed a significant association with the probability of failure. Patients with these features, along with those having non-chemosensitive tumours (in particular, non-small cell lung cancer), had a significantly worse actuarial survival. This study confirms that some pretreatment clinical data and pleural fluid parameters can predict both the outcome of pleurodesis and the survival of patients with malignant pleural effusion.

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“…(19) reported their results of short-term sclerotherapy (the procedure for pleurodesis in their study group was similar to the procedure that we used, but the sclerosing agent was tetracycline) for malignant pleural effusion by chest tube thoracostomy, with the results of short -term sclerotherapy being effective as the standard traditional sclerotherapy. In our series, we chose bleomycin as the sclerosing agent instead of tetracycline, because bleomycin injection into the pleural cavity is less painful and produces a shorter duration of fever than tetracycline injection.…”

Section: Discussionmentioning

confidence: 89%

Ultrasound-guided Small-bore Elecath Tube Insertion for the Rapid Sclerotherapy of Malignant Pleural Effusion

Hsu

Chiang

Chen

et al. 1998

Japanese Journal of Clinical Oncology

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Divisions of "Chest Medicine and 2Thoracic Surgery and Departments of 31nternal Medicine, 4Surgery and 5Pathology, Taichung Veterans General Hospital, Taichung, and 6National Yang-Ming University, Taipei, Taiwan Background: Traditional pleurodesis for malignant pleural effusion is performed by large-bore chest tube insertion with the instillation of sclerosing agents after the compressed lung re-expansion and pleural fluid drainage of 100-150 ml/day. This study was carried out to evaluate the possibility of rapid sclerotherapy for malignant pleural effusions by insertion of a small-bore Elecath tube (12-French) under ultrasound guidance and intrapleural injection of bleomycin 60 IU. Methods: Twenty-six patients, with 28 cytopathologically proven malignant pleural effusions (two patients had bilateral pleural effusions) and receiving the insertion of the Elecath tube for drainage, were included in our series. This rapid and short-term sclerosing method was performed and completed by intrapleural injection of bleomycin when the pleural effusion had been clearly drained by the small-bore Elecath tube and the compressed lung had fully re-expanded on follow-up chest radiographs. Results: Twenty patients with 22 pleural effusions underwent the intrapleural injection of bleomycin, with the results of pleurodesis being complete response 41% (9/22), partial response 36% (8/22) and failure 23% (5/22). Interestingly, among the 17 successful procedures of pleurodesis (complete response and partial response), 71% (12) procedures could be completed within 2 days (seven within one day and five within 2 days). The remaining unsuccessful procedures carried out on six patients without the injection of bleomycin were due to a non-re-expanded lung (n =3) and inadequate drainage (n =3); of these, four patients also received the large-bore chest tube insertion after the removal of the Elecath tube, but the compressed lung still could not re-expand. Conclusion: The method of rapid sclerotherapy for malignant pleural effusions by small-bore Elecath tube is promising, with a success rate achieving 77%, usually within 2 days.

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Efficacy of short term versus long term tube thoracostomy drainage before tetracycline pleurodesis in the treatment of malignant pleural effusions.

Abstract: Background

Cited by 92 publications

References 39 publications

Thoracoscopy: general overview and place in the diagnosis and management of pleural effusion

Thoracoscopy: general overview and place in the diagnosis and management of pleural effusion

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

Ultrasound-guided Small-bore Elecath Tube Insertion for the Rapid Sclerotherapy of Malignant Pleural Effusion

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