Chemical Pleurodesis Using Doxycycline and Viscum album Extract.
10.5090/kjtcs.2017.50.4.281
- Author:
Kyung Sub SONG
1
;
DongYoon KEUM
;
Jae Bum KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Korea. dongyoonkeum@gmail.com
- Publication Type:Original Article
- Keywords:
Pneumothorax;
Pleurodesis;
Viscum album;
Doxycycline
- MeSH:
Chest Pain;
Chest Tubes;
Doxycycline*;
Drainage;
Humans;
Pleural Effusion;
Pleurodesis*;
Pneumothorax;
Tetracycline;
Viscum album*;
Viscum*
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2017;50(4):281-286
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: In chemical pleurodesis for managing pulmonary air leak, tetracycline derivatives are commonly used, and their effectiveness has been established in many studies. Recently, a Viscum album extract was used in chemical pleurodesis. We compared the effects of V. album with those of a tetracycline derivative (doxycycline) to demonstrate the therapeutic effectiveness of the V. album extract in chemical pleurodesis for managing pulmonary air leak. METHODS: Between October 2010 and October 2016, chemical pleurodesis was performed using doxycycline in 40 patients and the V. album extract in 37 patients. Thirty-three patients were in the postoperative state after pulmonary resection, and 44 patients suffered from spontaneous pneumothorax. RESULTS: No statistically significant difference in the success rate was observed between the 2 groups (V. album extract and doxycycline). In both groups, chest pain was the most common complication. More patients in the doxycycline group complained of severe chest pain (42.1% vs. 13.5%, p=0.006). In the V. album extract group, 24.3% of the patients required a chest tube to drain the pleural effusion after cessation of the air leak (doxycycline group: 5%, p=0.022). Further, the amount of pleural effusion drained on the day after the last chemical pleurodesis in the V. album extract group was greater than that in the doxycycline group (162.2±170.2 mL vs. 97.0±77.2 mL, p=0.032). All patients were discharged from the hospital without complications after pleural effusion drainage. CONCLUSION: Considering that treatment using the V. album extract was less painful, V. album might be a feasible option for chemical pleurodesis. However, pleural effusion should be monitored carefully when using V. album extract for treating patients suffering from air leak.
