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Medical Pleurodesis with Povidone Iodine for Malignant Pleural Effusion in Low Income Countries

Received: 30 December 2021     Accepted: 23 May 2022     Published: 29 December 2022
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Abstract

Introduction: Chemical pleurodesis may be the best available treatment for recurrent and some pleural effusions trouble when the underlying cause cannot be treated. A wide variety of pleural irritants have been used, but the search for the ideal agent for pleurodesis continues. The aim of our study is to evaluate the efficacy and safety of iodo-povidone as an agent to treat recurrent pleural effusion. Materiel and methods: It’s a retrospective study of all cases treated in the surgery department of the regional hospital of Agadir for a recurrent pleural effusion in witch malignancy is confirmed. Results: Are included in the study 74 patients with a mean age of 61 years and a female dominance of gender. All patients in our series were symptomatic with a predominance of chest pain and dyspnea as revelatory signs. Lung cancer is the first cause incriminated in recurrent pleural effusion followed by breast cancer. All patient of the study were drained with a chest tube with caliber greater than 20 Fr and the success of the medical pleurodesis was considered in 91 % of cases with no signs of complications. Conclusion: Medical pleurodesis requires a multidisciplinary team and inter-professional communication between specialists in pulmonary medicine, thoracic surgery, and oncology, especially in patients with malignancy as an etiology of the disease. Povidone-iodine is a very effective sclerosing agent that allows effective pleural symphysis. Its cost, safety and availability represent the characteristics that have made its use especially in developing countries of major interest compared to other methods.

Published in International Journal of Biomedical Science and Engineering (Volume 10, Issue 4)
DOI 10.11648/j.ijbse.20221004.12
Page(s) 91-93
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Pleurodesis, Pleural Symphysis, Recurrent Effusion

References
[1] Walker-Renard PB, Vaughan LM, Sahn SA. Chemical pleurodesis for malignant pleural effusions. Ann Intern Med. 1994 Jan 1; 120 (1): 56-64. doi: 10.7326/0003-4819-120-1-199401010-00010. PMID: 8250457.
[2] Mierzejewski, M., Korczynski, P., Krenke, R. et al. Chemical pleurodesis – a review of mechanisms involved in pleural space obliteration. Respir Res 20, 247 (2019). https://doi.org/10.1186/s12931-019-1204-x
[3] Kilic, D., Akay, H., Kavukçu, Ş. et al. Management of Recurrent Malignant Pleural Effusion with Chemical Pleurodesis. Surg Today 35, 634–638 (2005). https://doi.org/10.1007/s00595-005-2996-5
[4] Lamb C, Li A, Thakkar D, Lee P. Pleurodesis. Semin Respir Crit Care Med. 2019 Jun; 40 (3): 375-385. doi: 10.1055/s-0039-1693997. Epub 2019 Sep 16. PMID: 31525812.
[5] Dikensoy O, Light RW. Alternative widely available, inexpensive agents for pleurodesis. Curr Opin Pulm Med. 2005 Jul; 11 (4): 340-4. doi: 10.1097/01.mcp.0000166587.24127.91. PMID: 15928503.
[6] Olivares-Torres CA, Laniado-Laborín R, Chávez-García C, León-Gastelum C, Reyes-Escamilla A, Light RW. Iodopovidone pleurodesis for recurrent pleural effusions. Chest. 2002 Aug; 122 (2): 581-3. doi: 10.1378/chest.122.2.581. PMID: 12171835.
[7] Agarwal R, Khan A, Aggarwal AN, Gupta D. Efficacy & safety of iodopovidone pleurodesis: a systematic review & meta-analysis. Indian J Med Res. 2012 Mar; 135 (3): 297-304. PMID: 22561614; PMCID: PMC3361864.
[8] Aelony Y. Talc pleurodesis vs iodopovidone. Chest. 2003 Apr; 123 (4): 1318-9; author reply 1319. doi: 10.1378/chest.123.4.1318. PMID: 12684335.
[9] Guinde J, Georges S, Bourinet V, Laroumagne S, Dutau H, Astoul P. Recent developments in pleurodesis for malignant pleural disease. Clin Respir J. 2018 Oct; 12 (10): 2463-2468. doi: 10.1111/crj.12958. PMID: 30252207.
[10] Teixeira LR, Vargas FS, Puka J, Acencio MM, Antonangelo L, Terra RM, Damico FM, Pitta FG, Marchi E. Effectiveness and safety of iodopovidone in an experimental pleurodesis model. Clinics (Sao Paulo). 2013 Apr; 68 (4): 557-62. doi: 10.6061/clinics/2013(04)19. PMID: 23778345; PMCID: PMC3634956.
[11] Wagenfeld L, Zeitz O, Richard G. Visual loss after povidone-iodine pleurodesis. N Engl J Med. 2007 Sep 20; 357 (12): 1264-5. doi: 10.1056/NEJMc070128. PMID: 17881764.
[12] Genofre EH, Vargas FS, Acencio MM, Antonangelo L, Teixeira LR, Marchi E. Talc pleurodesis: evidence of systemic inflammatory response to small size talc particles. Respir Med. 2009 Jan; 103 (1): 91-7. doi: 10.1016/j.rmed.2008.07.021. Epub 2008 Sep 11. PMID: 18789662.
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    Gourti Mouad, Ouchen Fahd, Makloul Mouhsine, Maidi Elmehdi. (2022). Medical Pleurodesis with Povidone Iodine for Malignant Pleural Effusion in Low Income Countries. International Journal of Biomedical Science and Engineering, 10(4), 91-93. https://doi.org/10.11648/j.ijbse.20221004.12

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    ACS Style

    Gourti Mouad; Ouchen Fahd; Makloul Mouhsine; Maidi Elmehdi. Medical Pleurodesis with Povidone Iodine for Malignant Pleural Effusion in Low Income Countries. Int. J. Biomed. Sci. Eng. 2022, 10(4), 91-93. doi: 10.11648/j.ijbse.20221004.12

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    AMA Style

    Gourti Mouad, Ouchen Fahd, Makloul Mouhsine, Maidi Elmehdi. Medical Pleurodesis with Povidone Iodine for Malignant Pleural Effusion in Low Income Countries. Int J Biomed Sci Eng. 2022;10(4):91-93. doi: 10.11648/j.ijbse.20221004.12

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  • @article{10.11648/j.ijbse.20221004.12,
      author = {Gourti Mouad and Ouchen Fahd and Makloul Mouhsine and Maidi Elmehdi},
      title = {Medical Pleurodesis with Povidone Iodine for Malignant Pleural Effusion in Low Income Countries},
      journal = {International Journal of Biomedical Science and Engineering},
      volume = {10},
      number = {4},
      pages = {91-93},
      doi = {10.11648/j.ijbse.20221004.12},
      url = {https://doi.org/10.11648/j.ijbse.20221004.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijbse.20221004.12},
      abstract = {Introduction: Chemical pleurodesis may be the best available treatment for recurrent and some pleural effusions trouble when the underlying cause cannot be treated. A wide variety of pleural irritants have been used, but the search for the ideal agent for pleurodesis continues. The aim of our study is to evaluate the efficacy and safety of iodo-povidone as an agent to treat recurrent pleural effusion. Materiel and methods: It’s a retrospective study of all cases treated in the surgery department of the regional hospital of Agadir for a recurrent pleural effusion in witch malignancy is confirmed. Results: Are included in the study 74 patients with a mean age of 61 years and a female dominance of gender. All patients in our series were symptomatic with a predominance of chest pain and dyspnea as revelatory signs. Lung cancer is the first cause incriminated in recurrent pleural effusion followed by breast cancer. All patient of the study were drained with a chest tube with caliber greater than 20 Fr and the success of the medical pleurodesis was considered in 91 % of cases with no signs of complications. Conclusion: Medical pleurodesis requires a multidisciplinary team and inter-professional communication between specialists in pulmonary medicine, thoracic surgery, and oncology, especially in patients with malignancy as an etiology of the disease. Povidone-iodine is a very effective sclerosing agent that allows effective pleural symphysis. Its cost, safety and availability represent the characteristics that have made its use especially in developing countries of major interest compared to other methods.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Medical Pleurodesis with Povidone Iodine for Malignant Pleural Effusion in Low Income Countries
    AU  - Gourti Mouad
    AU  - Ouchen Fahd
    AU  - Makloul Mouhsine
    AU  - Maidi Elmehdi
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    DO  - 10.11648/j.ijbse.20221004.12
    T2  - International Journal of Biomedical Science and Engineering
    JF  - International Journal of Biomedical Science and Engineering
    JO  - International Journal of Biomedical Science and Engineering
    SP  - 91
    EP  - 93
    PB  - Science Publishing Group
    SN  - 2376-7235
    UR  - https://doi.org/10.11648/j.ijbse.20221004.12
    AB  - Introduction: Chemical pleurodesis may be the best available treatment for recurrent and some pleural effusions trouble when the underlying cause cannot be treated. A wide variety of pleural irritants have been used, but the search for the ideal agent for pleurodesis continues. The aim of our study is to evaluate the efficacy and safety of iodo-povidone as an agent to treat recurrent pleural effusion. Materiel and methods: It’s a retrospective study of all cases treated in the surgery department of the regional hospital of Agadir for a recurrent pleural effusion in witch malignancy is confirmed. Results: Are included in the study 74 patients with a mean age of 61 years and a female dominance of gender. All patients in our series were symptomatic with a predominance of chest pain and dyspnea as revelatory signs. Lung cancer is the first cause incriminated in recurrent pleural effusion followed by breast cancer. All patient of the study were drained with a chest tube with caliber greater than 20 Fr and the success of the medical pleurodesis was considered in 91 % of cases with no signs of complications. Conclusion: Medical pleurodesis requires a multidisciplinary team and inter-professional communication between specialists in pulmonary medicine, thoracic surgery, and oncology, especially in patients with malignancy as an etiology of the disease. Povidone-iodine is a very effective sclerosing agent that allows effective pleural symphysis. Its cost, safety and availability represent the characteristics that have made its use especially in developing countries of major interest compared to other methods.
    VL  - 10
    IS  - 4
    ER  - 

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Author Information
  • Surgery Team, Medical University of Agadir, Agadir, Morrroco

  • Chest Surgery Department, Regional Hospital of Agadir, Agadir, Morrroco

  • Chest Surgery Department, Regional Hospital of Agadir, Agadir, Morrroco

  • Surgery Team, Medical University of Agadir, Agadir, Morrroco

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