Chest Meeting
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

COPYRIGHT © 2006 by the American College of Chest Physicians.
This Article
Right arrow Full Text (PDF)
Services
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Signes-Costa, J.
Right arrow Articles by Marco, J.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Signes-Costa, J.
Right arrow Articles by Marco, J.

Pleural Disease: Management


Wednesday, October 25, 2006

12:30 PM - 2:00 PM

PLEURODESIS IN PATIENTS WITH MALIGNANT PLEURAL EFFUSIONS: EFFICACY OF DOXYCYCLINE

Jaime Signes-Costa, MD*, Monica Llombart, MD, Eusebi Chiner, MD, Esther Pastor, MD, Ada Luz Andreu, MD, Elia Gomez-Merino, MD, Cristina Senent, MD, Ana Camarasa, MD, Juan Manuel Arriero, MD and Juan Marco, MD

Hospital Universitario San Juan, San Juan de Alicante, Spain

PURPOSE: Malignant pleural effusion (MPE) is a common problem in patients with malignancies. The aim of the study was to assess the efficacy of doxycycline with a small-bore (8F) thoracic tube in pleurodesis (P).

METHODS: During 5 years forty-one patients were found to be amenable to P. A small bore (8F) intercostal tube was placed at bed side in all patients. Demographics, clinical manifestations, properties of pleural fluid, complications, effectiveness and survival were analised.

RESULTS: There were 41 patients (26 female, 15 male), mean age 66±13 years. Origin from MPE were: breast 13 (32%), lung 8 (19.5%), ovarian 6 (14.6%), digestive 3 (7%), lymphoma 2 (5%) and others 9 (22%). Effusion was massive in 37%, two-thirds 22%, half 27%, and one-third 15%. Fluid showed a predominance of lymphocytes in 58%. Diagnostic yield of cytology was 74%. A succesful P (complete or partial) was acomplished in 25 (61 %). Mean overall survival was 201±40 days. Patients with a succesful P had a mean overall survival of 266 ±56 in contrast with failed P patients, 78 ±23 days (p=0006). Pain (34%) and fever (2%) were the only reported complications.

CONCLUSION: Doxycycline as chemical pleurodesis through small-bore thoracic tubes has a high success rate with low incidence of complications. Good response to P is associated with an increased survival.

CLINICAL IMPLICATIONS: Pleurodesis with doxycycline is a good option as palliative therapy in patients with symptomatic malignant pleural effusions. The use of small-bore tubes decreases the rate of clinically important complications.

DISCLOSURE: Jaime Signes-Costa, None.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American College of Chest Physicians.