PMID- 20961772
OWN - NLM
STAT- MEDLINE
DCOM- 20120112
LR  - 20220316
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 40
IP  - 2
DP  - 2011 Aug
TI  - Local iodine pleurodesis versus thoracoscopic talc insufflation in recurrent 
      malignant pleural effusion: a prospective randomized control trial.
PG  - 282-6
LID - 10.1016/j.ejcts.2010.09.005 [doi]
AB  - OBJECTIVE: To compare the efficacy, safety, and outcome of thoracoscopic talc 
      poudrage (TTP) versus povidone-iodine pleurodesis (PIP) through a thoracostomy 
      tube as a palliative treatment of pleural effusion due to metastatic breast 
      carcinoma (MBC). METHODS: A total of 42 MBC patients were prospectively enrolled 
      in a randomized controlled trial. Twenty-two patients received TTP (group A), 
      whereas 20 patients (group B) underwent pleurodesis by instilling povidone-iodine 
      through a thoracostomy tube, as a bedside procedure. RESULTS: The mean age was 
      48.2 +/- 9.9 (range: 29-64) years and 50.2 +/- 7 (range: 32-62) years for groups A 
      and B, respectively (p=ns). At presentation, all patients had moderate to severe 
      dyspnea, New York Heart Association (NYHA)>II and Medical Research Council (MRC) 
      dyspnea scale 3-5. Morbidity in both groups was low. Post-procedure analgesic 
      requirements due to severe pleuritic chest pain were higher in group A (18% vs 
      0%, p=0.2). Four patients in group A (18%) and one in group B (5%) were febrile 
      (>38 degrees C) within 48 h of the procedure. Both groups achieved good symptom control, 
      with improvement in MRC dyspnea scale (1-3). There were no in-hospital deaths. 
      Post-procedure hospital stay was lower in group B (p=0.009). The mean 
      progression-free interval was 6.6 (range 3-15) months. At follow-up (mean: 22.6 
      (range: 8-48) months), recurrence of significant pleural effusion requiring 
      intervention was noted in two and three patients in group A and group B, 
      respectively (p=ns). CONCLUSION: Povidone-iodine can be considered as a good 
      alternative to TTP to ensure effective pleurodesis for patients with malignant 
      pleural effusion due to MBC. The drug is available, cost effective and safe, can 
      be given through a thoracostomy tube and can be repeated if necessary.
CI  - Copyright (c) 2010 European Association for Cardio-Thoracic Surgery. Published by 
      Elsevier B.V. All rights reserved.
FAU - Mohsen, Tarek A
AU  - Mohsen TA
AD  - Department of Cardiothoracic Surgery, Kasr El Aini Hospital, Cairo University 
      Hospitals, El Manial, Egypt.
FAU - Zeid, Amany A Abou
AU  - Zeid AA
FAU - Meshref, Mohamed
AU  - Meshref M
FAU - Tawfeek, Nehad
AU  - Tawfeek N
FAU - Redmond, Karen
AU  - Redmond K
FAU - Ananiadou, Olga G
AU  - Ananiadou OG
FAU - Haj-Yahia, Saleem
AU  - Haj-Yahia S
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20101018
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
RN  - 14807-96-6 (Talc)
RN  - 85H0HZU99M (Povidone-Iodine)
SB  - IM
CIN - Eur J Cardiothorac Surg. 2011 Aug;40(2):277-9. PMID: 21194963
CIN - Eur J Cardiothorac Surg. 2012 May;41(5):1209. PMID: 22219431
MH  - Adult
MH  - Anesthesia, General/methods
MH  - Breast Neoplasms/complications
MH  - Dyspnea/etiology
MH  - Female
MH  - Humans
MH  - Insufflation/methods
MH  - Middle Aged
MH  - Palliative Care/methods
MH  - Pleural Effusion, Malignant/complications/*therapy
MH  - Pleurodesis/*methods
MH  - Povidone-Iodine/*administration & dosage
MH  - Prospective Studies
MH  - Recurrence
MH  - Talc/*therapeutic use
MH  - Thoracic Surgery, Video-Assisted/methods
MH  - Treatment Outcome
EDAT- 2010/10/22 06:00
MHDA- 2012/01/13 06:00
CRDT- 2010/10/22 06:00
PHST- 2010/01/10 00:00 [received]
PHST- 2010/09/01 00:00 [revised]
PHST- 2010/09/05 00:00 [accepted]
PHST- 2010/10/22 06:00 [entrez]
PHST- 2010/10/22 06:00 [pubmed]
PHST- 2012/01/13 06:00 [medline]
AID - S1010-7940(10)00763-3 [pii]
AID - 10.1016/j.ejcts.2010.09.005 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2011 Aug;40(2):282-6. doi: 10.1016/j.ejcts.2010.09.005. 
      Epub 2010 Oct 18.