[Treatment of malignant pleural effusion by percutaneous catheter drainage and chemical pleurodesis].
From June 1989 to December 1991, 93 patients affected by malignant pleural effusion (MPE) were treated as out patients using a ultrasound (US) guided catheter drainage (10F Percuflex pig-tail catheter-Medi-tech@(PTC) and chemical pleurodesis. The PTC was positioned when the MPE had been diagnosed by X-ray and all the patients had undergone some thoracentesis (mean 3.2, range 2-6). We started a chemical pleurodesis when the MPE was inferior to 100cc/day injecting Epidoxorubicin (EDX 30 mg/mq) in the pleural space on alternate day for three administrations, and then, a lyophilized Corynebacterium Parvum (Wellcome strain CN 6134) (CBP 14 mg) on alternate day for two administrations. The complete response rate of this treatment was 90% (86 pt) with a mean treatment period of 32.9 days (range 12-62). Complete response was assessed as total resolution of pleural effusion. Side effects were short-term hyperpyrexia in 65 cases (69.8%) and pleurodynia in 15 cases (15.7%). Three patients (3.1%) were complicated by a pleural infection which was resolved in 1 case and became chronic in 2. These findings indicate that this technique is an adequate treatment for the control of MPE inducing a clinical and quality-life improvement.
Chella
A
A
Cattedra e Scuola di Specializzazione di Chirurgia Toracica, Università degli Studi, Pisa.
Ribechini
A
A
Dini
P
P
Adamo
C
C
Mussi
A
A
Angeletti
C A
CA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000150:complications; D002404:Catheterization; D004322:Drainage / Q000295:instrumentation*; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D008654:Mesothelioma / Q000150:complications; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D010997:Pleural Neoplasms / Q000150:complications; D018700:Pleurodesis; D011425:Propionibacterium acnes
D015251:Epirubicin