medigraphic.com

2014, Number 2

Revista Cubana de Cirugía 2014; 53 (2)

Palliative treatment of malignant pleural effusions with chemical abrasion

Castellanos GJA, Mederos CON, Barrera OJC, Mederos TOL, López SA

Language: Spanish
References: 18
Page: 167-175
PDF size: 203.87 Kb.


ABSTRACT

Introduction: the treatment of the malignant pleural effusion poses a challenge for the surgeons, its permanent eradication has been a long struggle based on the use of a number of substances.
Objective: To show the results of the use of different chemical substances to fuse the pleuras in malignant pleural effusion.
Methods: one hundred and sixteen patients with malignant pleural effusions, who were treated with thoracentesis and chemical sclerotherapy at “Comandante Manuel Fajardo” university hospital from January 2001 through January 2013, participated in the study. Their diagnosis was based on clinical examination and imaging, with additional pleural fluid study. After the sample-taking, a collecting catheter and an instilled sclerosing solution were used to remove the whole pleural content, whereas bleomycin, tetracycline, amoxicillin and povidone iodine acted as irritating agents.
Results: the most frequent cause of pleural effusion was breast cancer, followed by lung and ovary cancers. The lung cancer was commonest in men and breast cancer in females. Females and the age of 60 years prevailed. In this group, 52.4% required two therapeutic sessions and 15.6 % showed no relapse after the first session.
Conclusions: the results were similar with all the used substances. The palliative intervention succeeded in improving the quality of life, releasing symptoms and reducing hospitalization.


REFERENCES

  1. Macías Felipe JR, Quintana Quintana M. Causas y prevalencia del derrame pleural en el Hospital general naval de alta especialidad. Medicina Interna de México. 2012;28(3):240-3.

  2. Xia H, Wang Xiao-J, Zhou Q, Shi HZ, Tong ZH. Efficacy and Safety of Talc Pleurodesis for Malignant Pleural Effusion: A Meta-Analysis. PLoS ONE. 2014;9(1):1-9. DOI: 10.1371/journal.pone.0087060.

  3. Agarwal R, Khan A, Aggarwal AN, Gupta D. Efficacy & safety of iodopovidone pleurodesis: a systematic review & meta-analysis. Indian Journal of Medical Research. 2012;3(1):297-304.

  4. Agarwal R, Paul AS, Aggarwal AN, Gupta D, Jindal SK. A randomized controlled trial of the efficacy of cosmetic talc compared with iodopovidone for chemical pleurodesis. Respirology. 2011;16(7):1064-9. DOI: 10.1111/j.1440-1843.2011.01999.x.

  5. Matsubara N, Itoh K, Mukai H, Nagai S. Long-term outcome of pleurodesis with OK- 432 in metastatic breast cancer: a new risk model for success from an analysis of 75 cases. International Journal of Clinical Oncology. 2012;17(5):470-476. DOI: 10.1007/s10147-011-0312-5.

  6. Maceachern P, Tremblay A. Pleural controversy: Pleurodesis versus indwelling pleural catheters for malignant effusions. Respirology. 2011;16(5):747-754. DOI: 10.1111/j.1440-1843.2011.01986.x.

  7. Schniewind B, Rose T, Woltmann N, Walter J, Becker T, Dohrmann P, Küchler T, Kurdow R. Clinical Outcomes and Health-Related Quality of Life after Thoracoscopic Talc Pleurodesis. Journal of Palliative Medicine. 2012; 15(1):37-42. DOI: 10.1089/jpm.2011.0149.

  8. Neto JD, de Oliveira SF, Vianna SP, Terra RM. Efficacy and safety of iodopovidone pleurodesis in malignant pleural effusions. Respirology. 2010; 15(1):115-8. DOI: 10.1111/j.1440-1843.2009.01663.x.

  9. Brunelli A, Varela G, Refai M, Jimenez MF, Pompili C, Sabbatini A, Aranda JL.Scoring System to Predict the Risk of Prolonged Air Leak After Lobectomy Ann. Thorac. Surg. 2010;90:204-9.

  10. Travaline JM, McKenna RJ, DeGiacomo T, et al. Treatment of persistent pulmonary air leaks using endobronchial valves. Chest. 2009;136:355-60.

  11. Collado Otero JC, Vázquez González JM, Almeida Varela R, Guerra Mesa JL, Rodríguez Borges Y. Resultados preliminares de la pleurodesis con talco para el tratamiento de los derrames pleurales de causa maligna. Rev Cubana Cir [revista en la Internet]. 2007 Mar [citado 2012 Jun 19];46(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034- 74932007000100003&lng=es

  12. Mederos Trujillo OL, Reyes Bolaño M, Moya Hernández Y. Comportamiento del derrame pleural maligno tratado con bleomicina. Revista 16 Abril. 2009 [Citado 15 de junio 2012];235. Disponible en: http://www.16deabril.sld.cu/rev/235/index.html

  13. Arguedas Quesada, JA. Derrame pleural. Act Méd Period. 2006; 63. Consultado 15 de mayo 2012. Disponible en: http://www.sld.cu/galerias/pdf/derrame_pleural.pdf

  14. Seijo L, Campo A, Belén A. Manejo ambulatorio del derrame pleural maligno mediante colocación de un catéter de drenaje tunelizado. Experiencia preliminar. Arch Bronconeumol. 2006;42:660-2.

  15. López-Segundo E, Salazar-Lezama MA. Métodos diagnósticos en el derrame pleural maligno. Rev Inst Nal Enf Resp Mex. 2003;16(2):70-3.

  16. Ferrer S. Marcadores tumorales en líquido pleural. Arch. Bronconeumol. 2004;36:295-7.

  17. Marchi E, Vargas FS, Teixeira LR, Acencio MM, Antonangelo L, Light RW. Intrapleural low-dose silver nitrate elicits more pleural inflammation and less systemic inflammation than low-dose talc. Chest. 2005;128(3):1798-804.

  18. López Ordóñez MA, Buitrago Ramírez R. Manejo ambulatorio del derrame pleural maligno. Rev Neumología. 2003[Citado 15 de mayo 2012];141. Disponible en: http://encolombia.com/medicina/neumologia/neum141-02arti-manejo.htm




2020     |     www.medigraphic.com