Chemical Pleurodesis Using Vincristine Patients With Malingant Pleural Effusion

Abstract

Pleural effusion cannot be controlled by repeated thoracentesis and surgical pleurectomy may not be considered appropriate for terminally ill patients. It has been suggested that chemical pleurodesis often results in the achievement of the best balance between efficacy and acceptability for terminally ill patients. Vincristine has been evaluated in our study for its efficacy as a sclerosing agent. Thirty patients suffering from malignant pleural effusion underwent 32 procedures of pleurodesis with vincristine as a palliative treatment in the Cardiothoracic Surgery Unit, Tanta University Hospitals, from October 2001 to September 2002. Malignant effusions were proven either by cytological examination with +ve malignant cells of the pleural aspirate or +ve pleural biopsy for malignant cells or establishd malignancy with associated pleural effusion where malignant cells couldn't be demonstrated in either pleural fluid or pleural tissues. All were investigated preoperatively radiographically either by plain chest x- rays or CT scanning with either pleural fluid cytology, pleural biopsy or bronchoscopic examinations. •• All underwent introduction of intercostal tube which left for drainage till the amount reduced to 100 ml/24 hours then we confirmed good lung expansion by

chest xcray, after that, tube clamped and intrapleural instillation ofvincristil1e was performed by injecting 2 mg diluted into 20 cc by a sterile normal saline into.