Chemical Pleurodesis Using Doxycycline and Extract.

BACKGROUND

In chemical pleurodesis for managing pulmonary air leak, tetracycline derivatives are commonly used, and their effectiveness has been established in many studies. Recently, a extract was used in chemical pleurodesis. We compared the effects of with those of a tetracycline derivative (doxycycline) to demonstrate the therapeutic effectiveness of the extract in chemical pleurodesis for managing pulmonary air leak.

METHODS

Between October 2010 and October 2016, chemical pleurodesis was performed using doxycycline in 40 patients and the extract in 37 patients. Thirty-three patients were in the postoperative state after pulmonary resection, and 44 patients suffered from spontaneous pneumothorax.

RESULTS

No statistically significant difference in the success rate was observed between the 2 groups ( extract and doxycycline). In both groups, chest pain was the most common complication. More patients in the doxycycline group complained of severe chest pain (42.1% vs. 13.5%, p=0.006). In the extract group, 24.3% of the patients required a chest tube to drain the pleural effusion after cessation of the air leak (doxycycline group: 5%, p=0.022). Further, the amount of pleural effusion drained on the day after the last chemical pleurodesis in the extract group was greater than that in the doxycycline group (162.2±170.2 mL vs. 97.0±77.2 mL, p=0.032). All patients were discharged from the hospital without complications after pleural effusion drainage.

CONCLUSION

Considering that treatment using the extract was less painful, might be a feasible option for chemical pleurodesis. However, pleural effusion should be monitored carefully when using extract for treating patients suffering from air leak.