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Article Type

Original Study

Abstract

Objectives The aim of this study was to compare between small-caliber catheter rapid pleurodesis and conventional chest tube pleurodesis as regards efficacy and hospital stay in patients with malignant pleural effusion (MPE). Background Chemical pleurodesis can be palliative for recurrent, symptomatic pleural effusions in patients who are not candidate for a thoracic surgical procedure. We hypothesized that pleurodesis as effective as the standard method could be accomplished with a rapid method of pleurodesis. Patients and methods This prospective randomized controlled trial included 30 patients with MPE. Patients were divided into two groups: group A, which underwent rapid pleurodesis with a small-caliber tube (8–14 Fr), and group B, which underwent conventional pleurodesis. Talc was the sclerosing agent that was used. The small-caliber tube was inserted under local anesthesia with total evacuation of pleural fluid, maximum 1.5 l, followed by gradual evacuation. Rapid pleurodesis was performed only after obtaining radiological evidence of complete evacuation of the fluid and the tube was clamped for 1 h. The fluid was drained over 1 h and the catheter removed and the patient discharged. The chest tube was inserted under local anesthesia with total evacuation of pleural fluid, maximum 1.5 l, followed by gradual evacuation. Pleurodesis was performed only after obtaining radiological complete evacuation of the fluid, daily drainage of less than 300 l. The tube was clamped for 1 h. The fluid was drained over 6–12 h and the tube was removed and then the patient was discharged from hospital. Results Our study included 15 patients in group A who underwent rapid pleurodesis and 15 patients in group B who underwent conventional pleurodesis. There was a significant difference between the two groups as regards hospital stay and postoperative pain. Conclusion Small-caliber tube drainage and rapid pleurodesis were shown to be efficient and demonstrated a good safety profile in treating MPEs.

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