Comparative Study of Two Sclerosants for Pleurodesis for Incurable Pleural Effusions and Pneumothorax

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.