الفهرس | Only 14 pages are availabe for public view |
Abstract Malignant pleural effusion (MPE) is a common but serious condition that is related with poor quality of life, morbidity and mortality. Its incidence and associated healthcare costs are rising and its management remains palliative, with median survival ranging from 3 to 12 months. During the last decade there has been significant progress in unravelling the pathophysiology of MPE, as well as its diagnostics, imaging, and management. Thirty three patients with malignant pleural effusion were included in this study to evaluate the efficacy and possible complications of ethanolamine oleate as a sclerosing substance that can be used in pleurodesis for malignant pleural effusion through ultrasound guided pigtail. This agent has been used extensively as a sclerosing agent for the sclerotherapy for esophageal varices and varicose veins in the legs . Since it has been diluted with both saline and glucose in these applications , Sclerosing therapy has been used for the treatment of esophageal varices and varicose leg veins since 1939.There were 9 (27.3%) males and 24 (72.7%) females ,there ages ranged from 28-78 years with a mean of 52.64 ± 10.46 years . They were diagnosed by cytological and/or hitopathological examinations. Pigtail catheter insertion was done to allow slow drainage of the effusion. Intrapleural injection of ethanolamine oleate was done after the chest x-ray showed complete lung expansion. Follow up of the patients was done by chest x-ray and chest ultrasonography. The efficacy and safety were assessed during the follow up of these patients. No complications were met in 14 cases (42.4%). In the other 19 patients ,7 patients (21.2%) developed fever (37.5- 38º C) after the injection of ethanolamine oleate, and responded within one day to antipyretics,11 patients (33.3%) developed mild chest pain which responded to simple analgesics, 8 patients (24.2 %) developed nausea , 4 patients (12.1%) developed vomiting and 2 patients (6.1%) developed hypotension which responded to saline infusion. 27 patients (81.8 %) showed complete response ,3 patients (9.1%) showed partial response and 3 patients (9.1%) showed no response.It is concluded from this study that etanolamine oleate is an inexpensive, safe, effective ,available and reliable sclerosing agent with minimal adverse effects. Also, pigtail catheter insertion is usually safe with little chance for complications. |