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Chemical agents for pleurodesis

Micaela Raices, Matías E Czerwonko, Agustin Dietrich, Alejandro Da Lozzo, Enrique Beveraggi, David Smith
Symptomatic neoplastic pleural effusion (SNPE) is a significant cause of morbidity in patients with advanced neoplastic disease. These patients often present a deteriorated general condition which prevents them from undergoing pleurodesis with video-assisted thoracic surgery (VATS). We developed a minimally invasive therapeutic protocol specially designed for this population, achieved by combining chemical pleurodesis with placement of small-bore pleural catheters (PC), which resulted in early hospital discharge, low morbimortality and good therapeutic results...
August 31, 2017: Updates in Surgery
R J Hallifax, A Yousuf, H E Jones, J P Corcoran, I Psallidas, N M Rahman
OBJECTIVES: Spontaneous pneumothorax is a common pathology. International guidelines suggest pleurodesis for non-resolving air leak or recurrence prevention at second occurrence. This study comprehensively reviews the existing literature regarding chemical pleurodesis efficacy. DESIGN: We systematically reviewed the literature to identify relevant randomised controlled trials (RCTs), case-control studies and case series. We described the findings of these studies and tabulated relative recurrence rates or ORs (in studies with control groups)...
December 2017: Thorax
R Hasan, O S Khan, M Aftabuddin, A M Razzaque, G A Chowdhury
Malignant pleural effusion is a common complication of primary and metastatic pleural malignancies. Pleurodesis for the management of malignant pleural effusion is intended to achieve symphysis between parietal and visceral pleura, and to prevent relapse of pleural effusion. Many chemical agents are tried to induce inflammation and damage of the pleural mesothelial layer to achieve this symphysis. Hemorrhagic pleural effusion, especially in the right hemithorax commonly occurs as presentation of primary and metastatic pleural malignancies...
April 2016: Mymensingh Medical Journal: MMJ
Jeong Su Cho, Kook Joo Na, Yongjik Lee, Yeong Dae Kim, Hyo Yeong Ahn, Chang Ryul Park, Young Chul Kim
PURPOSE: Malignant pleural effusion (MPE) is common in patients with advanced cancer. Chemical pleurodesis can be considered for MPE that do not respond to chemotherapy, radiotherapy, or therapeutic thoracentesis. However, it is not yet clear which agent is more effective and safer in chemical pleurodesis. METHODS: This study was designed as a single arm, multicenter, and open-label phase III clinical trial to evaluate efficacy and safety of chemical pleurodesis using mistletoe extraction (ABNOVAviscum(®) Injection)...
2016: Annals of Thoracic and Cardiovascular Surgery
Nevin Yilmaz, Arife Zeybek, Benjamin Tharian, Ugur Eser Yilmaz
Chemical pleurodesis is one of the therapeutic tools to control hepatic hydrothorax. Tetracycline and derivatives have been widely accepted as an effective and safe treatment for the purpose, but availability is the big concern. Tigecycline is an antibiotic derivative of tetracycline, which has demonstrated to be an effective pleurodesing agent in animal models. The aim of the study was to document two successful tigecycline pleurodesis in patients with decompensated liver cirrhosis, who were not candidates for liver transplantation...
2015: Surgical Case Reports
Elena Orlandi, Patrizia Mordenti, Adriano Zangrandi, Luigi Cavanna
BACKGROUND: Malignant pleural effusion (MPE) is an extremely common problem affecting cancer patients with advanced disease. The current therapy for MPE is local treatment, such as thoracentesis, chemical pleurodesis, intracavitary administration of anticancer drugs and systemic therapy. However, the management of MPE is still unsatisfactory. CASE: We report a case of MPE secondary to human epidermal growth factor receptor 2 (HER2)-positive gastric cancer that was successfully treated with intrapleural trastuzumab...
2014: Chemotherapy
Suk Ju Cho, Su Wan Kim, Jee Won Chang
Chemical pleurodesis is widely recommended in the treatment of pulmonary air leak of different etiologies as well as malignant pleural effusions and chylothorax. Conventional chemical pleurodesis using erythromycin, tetracycline, hydrophilic fumed silica, autologous blood and talc slurry has been standardized, and its complications, including high fever, intractable chest pain, and acute lung injury, seem to be frequent. Viscum album extract is a new chemical agent for pleurodesis, and only a few studies have reported outcomes of such chemical pleurodesis in the treatment of malignant pleural effusion...
2014: Multidisciplinary Respiratory Medicine
Pierre-Benoit Pagès, Jean-Philippe Delpy, Pierre-Emmanuel Falcoz, Pascal-Alexandre Thomas, Marc Filaire, Françoise Le Pimpec Barthes, Marcel Dahan, Alain Bernard
BACKGROUND: Few randomized controlled trials have been published on outcomes after treatment of spontaneous pneumothorax. The objective of this study was to assess recurrence, pulmonary complications, prolonged air leak, and hospital duration of stay in patients undergoing videothoracoscopic surgery (VATS) or thoracotomy for spontaneous pneumothorax. METHODS: From January 2005 to December 2012, 7,396 patients underwent operations for spontaneous pneumothorax and were entered into the French national database...
January 2015: Annals of Thoracic Surgery
F Hmami, A Oulmaati, C Bouchikhi, A Banani, A Bouharrou
Idiopathic congenital chylothorax refers to abnormal accumulation of lymphatic fluid within the pleural space due the disruption of the thoracic duct or its lymphatic tributaries. It is a relatively rare disease and a cause of neonatal respiratory distress with major nutritional and immunological consequences. Therefore, it is critical to decrease pleural effusion promptly. Conservative treatment is always started as soon as the diagnosis is made, and refractory cases require chemical pleurodesis or surgery...
September 2014: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Jin-Shing Chen, Wing-Kai Chan, Pan-Chyr Yang
PURPOSE OF REVIEW: The role of chemical pleurodesis in the treatment of primary spontaneous pneumothorax remains unclear. According to current practice guidelines, chemical pleurodesis is reserved for patients who are unable or unwilling to have surgery. Some recent studies showed that intrapleural minocycline pleurodesis could decrease the rate of pneumothorax recurrence, when used either as the initial treatment for simple pneumothorax after successful aspiration and drainage or as an adjuvant treatment for complicated or recurrent pneumothorax following thoracoscopic surgery...
July 2014: Current Opinion in Pulmonary Medicine
Hwa Jin Cho, Kook Joo Na, Do Wan Kim, Young Earl Choi, Jae Sook Ma, In Seok Jeong
UNLABELLED: Congenital chylothorax is a rare condition, but it is the most common cause of pleural effusion in neonates and infants. Here, we report on the first trials of the intrapleural instillation of an extract of Viscum album (European mistletoe) (Abnobaviscum Q®) in two infants with congenital chylothorax that was refractory to standard conservative management and thoracic duct ligation. CONCLUSION: The clinical course of both children improved with no side effects related to the extract after following up the children for 2 years and 9 months, respectively...
June 2014: European Journal of Pediatrics
Cheng-Hung How, Hsao-Hsun Hsu, Jin-Shing Chen
Pneumothorax is defined as the presence of air in the pleural cavity. Spontaneous pneumothorax, occurring without antecedent traumatic or iatrogenic cause, is sub-divided into primary and secondary. The severity of pneumothorax could be varied from asymptomatic to hemodynamically compromised. Optimal management of this benign disease has been a matter of debate. In addition to evacuating air from the pleural space by simple aspiration or chest tube drainage, the management of spontaneous pneumothorax also focused on ceasing air leakage and preventing recurrences by surgical intervention or chemical pleurodesis...
December 2013: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Cecilia Menna, Claudio Andreetti, Mohsen Ibrahim, Giulio Maurizi, Camilla Poggi, Rocco Barile, Francesco Cassiano, Erino A Rendina
BACKGROUND: Chemical pleurodesis is the procedure of choice in the management of recurrent malignant pleural effusions (MPE). Talc is probably the most effective sclerosant, with a success rate of 80%. The aim of this study is to demonstrate the effectiveness of silver nitrate solution (SNS) pleurodesis after an unsuccessful thoracoscopic talc poudrage. METHODS: Between 2011 and 2013 one hundred and nine patients with unilateral MPE underwent thoracoscopic talc poudrage...
2013: BioMed Research International
Takeo Inoue, Atsuko Ishida, Miho Nakamura, Hiroki Nishine, Masamichi Mineshita, Teruomi Miyazawa
OBJECTIVE: Malignant pleural effusions are commonly treated with tube drainage followed by chemical pleurodesis to maintain the patient's quality of life. While talc is now accepted to be a worldwide gold-standard sclerosing agent for treating malignant pleural effusion, it is not yet approved in Japan. Instead, many patients are administered OK-432 for pleurodesis, which carries the risk of complications such as high-grade fever, chest pain, anaphylactic shock, interstitial pneumonia and acute renal failure...
2013: Internal Medicine
Bing-ling Xu, Jin-quan Yu, Ke-jing Tang, Da-yue Liu, Yu-kun Kuang
INTRODUCTION: In patients with refractory pleural effusion or pneumothorax, fever and elevated level of white blood cell count (WBC) are frequently observed after chemical pleurodesis with intrapleural injection of OK-432, which make it difficult to differentiate whether it was from the side effects of OK-432 or concurrent bacterial infection. OBJECTIVE: Procalcitonin (PCT) levels were measured before and after pleurodesis so as to discuss whether PCT is useful for distinguishing between the side effects of OK-432 and concurrent bacterial infection...
January 2014: Clinical Respiratory Journal
Nadim Srour, Kayvan Amjadi, Alan Forster, Shawn Aaron
BACKGROUND: Management of malignant pleural effusion typically involves insertion of an indwelling pleural catheter (IPC) or chemical pleurodesis with agents such as talc. OBJECTIVES: To compare these management strategies with regard to success of pleural effusion management. METHODS: A retrospective cohort study was designed comparing patients with malignant and paramalignant pleural effusions and Eastern Cooperative Oncology Group performance status <4 managed with IPC insertion or talc pleurodesis (TP) through tube thoracostomy during noncontemporary three-year periods at a single centre...
March 2013: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Gholamali Godazandeh, Nasim Haji Qasemi, Mohammad Saghafi, Meisam Mortazian, Pouya Tayebi
OBJECTIVE: Overtime, malignant pleural effusion (MPE) arises in advanced-stages of malignancies and frequently heralds a poor prognosis. If the underlying malignancy is chemo sensitive, systemic chemotherapy may control pleural effusion. A common method for the management of the patients with refractory MPE is pleurodesis through the introduction of sclerosing agents such as talc, bleomycin administered/instilled into the pleural cavity. However, the present prospective study aimed to investigate the efficacy and safety of pleurodesis with povidone-iodine (Betadine) in patients with MPE admitted in Sari General Hospital during 2008-2011...
April 2013: Journal of Thoracic Disease
Shahryar Hashemzadeh, Khosrow Hashemzadeh, Kamran Mamaghani, Elnaz Ansari, Raheleh Aligholipour, Samad Ej Golzari, Kamyar Ghabili
UNLABELLED: HASH(0x4c124e0) BACKGROUND: None of the current pleurodesing agents fulfil all the criteria for best pleural sclerosant. Therefore, the search for the ideal agent for chemical pleurodesis still continues. The aim of the present study was to compare the effectiveness of erythromycin, tetracycline, Aerosil™ 200 (hydrophilic fumed amorphous silica), and erythromycin plus Aerosil™ 200 in producing pleurodesis in rats. In the present study, talc was not used as a pleurodesing agent due to an unavailability of its sterile and pure form in Iran...
2012: Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
Stefano M M Basso, Francesco Mazza, Bernardo Marzano, Davide A Santeufemia, Giordano B Chiara, Franco Lumachi
Malignant pleural effusion (MPE) is a common, debilitating complication of several types of advanced malignancy, which may significantly reduce the quality of life of patients. There are several options to treat MPE, including thoracentesis, placement of a long-term indwelling pleural catheter and chemical pleurodesis. The best treatment is still debated, but talc remains the agent of choice to achieve pleurodesis. Forty-six patients (28 men and 18 women; median age 67 years, range 47-82 years) with MPE related to different malignancies underwent video-assisted thoracoscopy talc pleurodesis...
November 2012: Anticancer Research
Satoshi Iyama, Tsutomu Sato, Kazuyuki Murase, Shohei Kikuchi, Yusuke Kamihara, Kaoru Ono, Kohichi Takada, Koji Miyanishi, Yasushi Sato, Rishu Takimoto, Masayoshi Kobune, Takuro Obama, Masahiro Miyajima, Atsushi Watanabe, Tetsuya Higami, Yasuo Hirayama, Junji Kato
Pneumothorax associated with chronic graft-versus-host disease (cGVHD) after stem cell transplantation is a rare complication. Autologous blood has been used successfully for pleurodesis, which was less toxic than chemical agents. However, when pneumothorax is resistant to pleurodesis, no other procedure is more effective and conservative. Here, we describe a case of myelodysplastic syndromes complicated with cGVHD-related pneumothorax. His pneumothorax has been resistant to pleurodesis using autologous blood and was treated successfully with fibrin glue sealant...
2012: Internal Medicine
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