Thorac Cardiovasc Surg 2009; 57(2): 102-106
DOI: 10.1055/s-2008-1039103
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

A Comparison of the Effectiveness of Talc, Polidocanol and Ethanol as Pleural Sclerosing Agents in Rabbits

B. Çelik1 , O. Aydin2 , A. Cilingir2 , A. Basoglu1
  • 1Department of Thoracic Surgery, Ondokuz Mayis University Medical School, Samsun, Turkey
  • 2Department of Pathology, Ondokuz Mayis University Medical School, Samsun, Turkey
Further Information

Publication History

received June 25, 2008

Publication Date:
24 February 2009 (online)

Abstract

Background: Aim of the study was to compare the pleurodesis results from the intrapleural injection of talc, polidocanol and ethanol into the rabbit pleura. Methods: Twenty-nine New Zealand white rabbits were randomized into three groups for the intrapleural administration of 200 mg/kg (n = 10) of talc, 15 mg/kg (n = 10) of 3 % polidocanol or 1 mL (n = 9) of 4.2 % ethanol in 2 mL saline solution, respectively. The pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of inflammation, thickness, cellularity, neovascularity and mesothelial cell proliferation in both pleura. Results: The mean degrees of gross pleurodesis were 2.0 ± 0.66 (on a scale from 0 to 4) for talc, 2.2 ± 0.91 for polidocanol and 0.7 ± 0.86 for ethanol. The parietal pleura thickness was 191 ± 213.6 µm, 236 ± 224.6 µm and 45 ± 44.2 µm, while the visceral pleura thickness was 109 ± 103.7 µm, 164 ± 161.4 µm and 48 ± 42.2 µm in the talc, polidocanol and ethanol groups, respectively. The results of microscopic examination were similar in the talc and polidocanol groups. Conclusion: The intrapleural injection of polidocanol produces better pleurodesis than does the intrapleural injection of talc or ethanol in rabbits. Because of the efficacy of polidocanol as a sclerosing agent, its use in humans should be considered after further animal studies.

References

  • 1 Walker-Renard P B, Vaughan L M, Sahn S A. Chemical pleurodesis for malignant pleural effusions.  Ann Intern Med. 1994;  120 56-64
  • 2 Kennedy L, Sahn S A. Talc pleurodesis for the treatment of pneumothorax and pleural effusion.  Chest. 1994;  106 1215-1222
  • 3 de Campos J R, Vargas F S, de Campos Werebe E. et al . Thoracoscopic talc poudrage: a 15-year experience.  Chest. 2001;  119 801-806
  • 4 Henschel O. Sclerosing of varicose veins sclerotheraphy with Aethoxysklerol-Kreussler. Wiesbaden; Chemische Fabrik Kreussler & Co. GmbH 1968
  • 5 Gade J, Brasso K, Junge J, Olesen H P. Pleurodesis with polidocanol in pigs. An experimental study.  Chest. 1994;  105 908-910
  • 6 Lund L. Treatment of testicular hydrocele with aspiration and injection of polidocanol (Ethoxyscerol).  Ugeskr Laeger. 1988;  150 1470-1471
  • 7 Cetin B, Kockaya E A, Atalay C, Akay M T. Polidocanol at different concentrations for pleurodesis in rats.  Surg Today. 2005;  35 1066-1069
  • 8 Çelik B, Demircan S, Bek Y, Basoglu A. Comparison of talc and oxytetracycline with different pleurodesis methods in treatment of malignant pleural effusion.  Turkish J Thorac Cardiovasc Surg. 2004;  12 172-179
  • 9 Bethune N. Pleural poudrage: new technique for deliberate production of pleural adhesions as a preliminary to lobectomy.  J Thorac Surg. 1935;  4 251-261
  • 10 Rehse D H, Aye R W, Florence M G. Respiratory failure after talc pleurodesis.  Am J Surg. 1999;  177 437-440
  • 11 Goldman P M. Polidocanol (Aethoxysklerol) for sclerotherapy of superficial venules and telengiectasias.  J Dermatol Surg Oncol. 1989;  15 204-209
  • 12 Cetin B, Kockaya E A, Atalay C, Akay M T, Cetin A. The efficacy of polidocanol in pleurodesis in rats.  Surg Today. 2003;  33 688-692
  • 13 Ruckdeschel J C, Moores D, Lee J Y. et al . Intrapleural therapy for malignant pleural effusions. A randomized comparison of bleomycin and tetracycline.  Chest. 1991;  100 1528-1535
  • 14 Ferrer J, Villarino M A, Tura J M, Traveria A, Light R W. Talc preparations used for pleurodesis vary markedly from one preparation to another.  Chest. 2001;  119 1901-1905
  • 15 Ferrer J, Montes J F, Villarino M A, Light R W, Garcia-Valero J. Influence of particle size on extrapleural talc dissemination after talc slurry pleurodesis.  Chest. 2002;  122 1018-1027
  • 16 Werebe E C, Pazetti R, Milanez de Campos J R. et al . Systemic distribution of talc after intrapleural administration in rats.  Chest. 1999;  115 190-193
  • 17 Campos J R, Werebe E C, Vargas F S, Jatene F B, Light R W. Respiratory failure due to insufflated talc.  Lancet. 1997;  349 251-252
  • 18 Karsner H T, Swanbeck C E. The removal of particulate matter from the pleura.  J Med Res. 1920;  42 91-98
  • 19 Genofre E H, Vargas F S, Antonangelo L, Teixeira L R, Vaz M A, Marchi E, Capelozzi V L. Ultrastructural acute features of active remodeling after chemical pleurodesis induced by silver nitrate or talc.  Lung. 2005;  183 197-207
  • 20 Ferrer J, Montes J F, Villarino M A, Light R W, Garcia-Valero J. Influence of particle size on extrapleural talc dissemination after talc slurry pleurodesis.  Chest. 2002;  122 1018-1027
  • 21 Antonangelo L, Vargas F S, Teixeira L R. et al . Pleurodesis induced by talc or silver nitrate: evaluation of collagen and elastic fibers in pleural remodeling.  Lung. 2006;  184 105-111

Dr. Burçin Çelik

Department of Thoracic Surgery
Ondokuz Mayis University Medical School

Kurupelit

55139 Samsun

Turkey

Phone: + 90 36 23 12 19 19

Fax: + 90 36 24 57 60 41

Email: cburcin@hotmail.com