Comparative Study of Two Sclerosants for Pleurodesis for Incurable Pleural Effusions and Pneumothorax
E. E. Ekpe *
Cardiothoracic Surgery Unit, Department of Surgery, University of Uyo Teaching Hospital, P.M.B. 1136, Uyo, Nigeria.
M. C. Ikpe
Department of Radiology, University of Uyo Teaching Hospital, P.M.B. 1136, Uyo, Akwa Ibom State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Pleurodesis is indicated in thoracic pathologies associated with pleural effusions or pneumothoraces resulting from incurable diseases and therefore risked with high chance of recurrence
Objective: To compare the success rates of the oral forms of tetracycline and injectable form of cyclophosphamide as chemical pleurodesants in clinical practice.
Materials and Methods: Prospective study.
Results: There were 33 patients who underwent pleurodesis of 40 pleural spaces (bilateral in 7 patients) M: F=1:2.3 (10 vs 23) Age range: 15-80 years (mean= 49 years). The primary outcome measure was taken at four weeks post pleurodesis. This was the success rate of the pleurodesis which was taken as non-recurrence of pleural effusion or pneumothorax at four weeks. At one month, 16(80%) of the pleural spaces that underwent pleurodesis with tetracycline hydrochloride were free from recurrence which makes for 80% success rate and 20% (recurrence) failure rate for tetracycline. The equivalent figures for cyclophosphamide were 85% and 15% respectively.
Conclusion: The oral form of tetracycline and cyclophosphamide injection can give approximately same outcome as sclerosants for pleurodesis in appropriate patients.
Keywords: Pleurodesis, cyclophosphamide, tetracycline.