Chemical pleurodesis using bleomycin in treatment of patients with transsudative pleural effusion in hepatic failure
https://doi.org/10.24884/0042-4625-2017-176-3-52-55
Abstract
OBJECTIVE. The authors analyzed the efficacy of bleomycin application as sclerosing agent in patients with transudative pleural effusion in consequence of hepatic failure. MATERIAL AND METHODS. The research included 7 patients with right side hepatic transudative pleural effusion who didn’t respond to conservative medical treatment. Drainage of the right pleural cavity with following injection of bleomycin were performed for all the patients. RESULTS. This procedure was effective in 6 out of 7 patients (86 %). There was a single case of recurrence and lethal outcome (14 %) due to hepatic coma. There weren’t noted any severe side effects during 6 months after induction of bleomycin. CONCLUSIONS. Pleurodesis using bleomycin appeared to be effective and safe method of treatment for patients with hepatic transudative pleural effusions.
About the Authors
A. L. Akopov
I.P.Pavlov First St. Petersburg State Medical University
Russian Federation
Russian Federation
A. .. Carlson
I.P.Pavlov First St. Petersburg State Medical University
Russian Federation
Russian Federation
S. D. Gorbunkov
I.P.Pavlov First St. Petersburg State Medical University
Russian Federation
Russian Federation
A. S. Agishev
I.P.Pavlov First St. Petersburg State Medical University
Russian Federation
Russian Federation
A. I. Romanikhin
I.P.Pavlov First St. Petersburg State Medical University
Russian Federation
Russian Federation
References
1. Акопов А. Л. Плевральный выпот при раке лёгкого // Пульмонология. 2001. № 4. С. 72.
2. Акопов А. Л., Кондратьев В. Б. Лечение метастатических экссудативных плевритов внутриполостным введением блеомицетина // Вопросы онкологии. 1999. № 4. С. 411.
3. Клименко В. Н., Чайка О. В., Щербаков А. М. и др. Оценка эффективности видеоторакоскопического плевродеза в лечении рецидивирующих опухолевых экссудативных плевритов // Ученые записки СПбГМУ им. акад. И. П. Павлова. 2009. Т. XVI, № 3. С. 94-98.
4. Borchardt J., Smirnov A., Metchnik L. et al. Treating hepatic hydrothorax // Br. Med. J. 2003. Vol. 326. P. 751-752.
5. Hefner J. E., Unruh L. C. Tetracycline pleurodesis: adios, farewell, adieu // Chest 1992. Vol. 101. P. 64-66.
6. Huang P. M., Chang Y. L., Yang C. Y., Lee Y. C. The morphology of diaphragmatic defects in hepatic hydrothorax: thoracoscopic finding // J. Thorac. Cardiovasc. Surg. 2005. Vol. 130. P. 141-145.
7. Kalambokis G., Fotopoulos A., Economou M., Tsianos E. V. Beneficial haemodynamic and renal sodium handling effects of combined midodrine and octreotide treatment in a cirrhotic patient with large hepatic hydrothorax and mild ascites // Nephrol. Dial. Transplant. 2005. Vol. 20. P. 2583.
8. Kirschner P.A. Porous diaphragm syndromes // Chest. Surg. Clinic. N. Amer. 1998. Vol. 8. P. 449-472.
9. Liu L. U., Haddadin H. A., Bodian C. A. et al. Outcome analysis of cirrhotic patients undergoing chest tube placement // Chest. 2004. Vol. 126. P. 142-148.
10. Milanez de Campos J. R., Filho E. A. et al. Thoracoscopy and talc poudrage in the management of hepatic hydrothorax // Chest. 2000. Vol. 118. P. 13-17.
11. Moore K. P., Wong F., Gines P. et al. The management of ascites in cirrhosis: report on the consensus conference of the International Ascites Club // Hepatology. 2003. Vol. 38. P. 258-266.
12. Mouroux J., Perrin C., Venissac N. et al. Management of pleural effusion of cirrhotic origin // Chest. 1996. Vol. 109. P. 1093-1096.
13. Nathan J., Richard N., Chris H., Darcy M. Thoracentesis complication rates on the medical clinical teaching unit: does ultrasonography make a difference? // Chest 2011. Vol. 140. P. 497A.
14. Northup P. G., Harmon R. C., Pruett T. L. et al. Mechanical pleurodesis aided by peritoneal drainage: procedure for hepatic hydrothorax // Ann. Thorac. Surg. 2009. Vol. 87. P. 245-250.
15. Rodriguez-Panadero F., Montes-Worboys A. Mechanisms of pleuro desis // Respiration. 2012. Vol. 83. P. 91-98.
16. 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. Vol. 100. P. 1528-1535.
17. Runyon B. A., Greenblatt M., Ring M. H. C. Hepatic hydrothorax is a relative contraindication to chest tube insertion // Amer. J. Gastroenterol. 1986. Vol. 81. P. 566-567.
18. Spencer E. B., Cohen D. T., Darcy M. D. Safety and efficacy of transjugular intrahepatic portosystemic shunt creation for the treatment of hepatic hydrothorax // J. Vasc. Interv. Radiol. 2002. Vol. 13. P. 385-390.
19. Walker-Renard P.B., Vaughan L. M., Sahn S. A. Chemical pleurodesis for malignant pleural effusions // Ann. Intern. Med. 1994. Vol. 120. P. 56-64.
20. Zenda T., Miyamoto S., Murata S., Mabuchi H. Detection of diaphragmatic defect as the cause of severe hepatic hydrothorax with magnetic resonance imaging // Amer. J. Gastroenterol. 1998. Vol. 93. P. 2288-2289.
Review
For citations:
Akopov A.L., Carlson A..., Gorbunkov S.D., Agishev A.S., Romanikhin A.I. Chemical pleurodesis using bleomycin in treatment of patients with transsudative pleural effusion in hepatic failure. Grekov's Bulletin of Surgery. 2017;176(3):52-55. (In Russ.) https://doi.org/10.24884/0042-4625-2017-176-3-52-55
Views:
894
Email this article 