TO STUDY IODINE VERSUS TALC PLEURODESIS IN RECURRENT SUSPICIOUS MALIGNANT PLEURAL EFFUSION AND RECURRENT PNEUMOTHORAX: A COHORT STUDY.

Swadesh Kumar  Mohanty; R S  Negi; Sunil  Sharma; Smita Rani  Samal

doi:10.51168/sjhrafrica.v5i6.1225

Authors

Swadesh Kumar Mohanty Senior Resident,Department of Pulmonary Medicine, sleep and critical care,All India Institute of Medical Sciences, Bhubaneswar, India
R S Negi Professor, Department of Pulmonary Medicine,Indira Gandhi Medical College, Shimla, India
Sunil Sharma Professor, Department of Pulmonary Medicine,Indira Gandhi Medical College, Shimla, India
Smita Rani Samal Assistant Professor,Department of Dermatology,SCB Medical College and Hospital, Cuttack, India

DOI:

https://doi.org/10.51168/sjhrafrica.v5i6.1225

Keywords:

Malignant pleural effusion, Pleurodesis, Talc, Povidone-iodine, Thoracoscopy

Abstract

Background

Malignant pleural effusion (MPE) significantly diminishes the quality of life in individuals with advanced lung cancer and other malignancies. Effective management is crucial for symptom relief and improved outcomes. This study compares the safety, efficacy, and success rates of talc versus povidone-iodine pleurodesis in patients with recurrent MPE and spontaneous pneumothorax.

Methods

The study involved 66 MPE patients who underwent medical thoracoscopy followed by either talc (Group A) or povidone-iodine (Group B) pleurodesis. Data on demographics, clinical presentation, radiological findings, pleural fluid analysis, thoracoscopic findings, complications, and pleurodesis outcomes were collected. Statistical analysis compared the efficacy and safety of both methods.

Results

The study comprised 66 participants, with an average age of 57.86 ± 9.92 years. Pleurodesis was successful in 90.90% of the talc group (n=30) and 100% of the povidone-iodine group (n=33). Complications associated with talc included ARDS (4.5%, n=1) and empyema (4.5%, n=1), whereas povidone-iodine was associated with higher incidences of pain (63.63%, n=14) but no cases of ARDS or empyema. The mean duration of intercostal tube drainage was 4.8 ± 2.1 days for talc and 4.2 ± 1.8 days for povidone-iodine. The mean hospital stay was 8.4 ± 1.8 days for talc and 9.2 ± 2.2 days for povidone-iodine. Povidone-iodine pleurodesis had a slightly higher success rate and fewer severe complications compared to talc pleurodesis.

Conclusion

Both talc and povidone-iodine pleurodesis are effective for managing MPE, with povidone-iodine showing a higher success rate and fewer severe complications. These findings suggest that povidone-iodine may be a safer alternative to talc for pleurodesis in MPE patients.

Recommendations

Further research is recommended to optimize pleurodesis techniques and agents, considering patient-specific factors to improve outcomes and minimize complications. Clinicians should weigh the benefits and risks of each pleurodesis agent to make informed treatment decisions.