Pleurodesis with povidone iodine in patients with malignant pleural effusion in a tertiary center in Nigeria

Abstract

Introduction malignant pleural effusion occurs as a consequence of a primary or metastatic malignant process involving the pleura. The aim of pleurodesis is to prevent re-accumulation of the effusion and avoid the need for repeated hospitalization. Povidone iodine has been used in other climes for pleurodesis with good results. The aim of this study is to assess the efficacy and safety of povidone iodine in producing pleurodesis as compared to tetracycline. Methods the study is a prospective experimental study. The patients are randomized into two groups A (tetracycline-control) and B (povidone iodine). All patients are assessed with chest X-ray after 1 week and 1 month. The responses were ascribed as complete, partial or failure. Results thirty patients were recruited into this study, 15 patients in each group A (tetracycline) and B (povidone iodine). The mean age was 45.7±14.24 years. The commonest primary malignancy was Breast cancer (70%) followed by bronchogenic cancer (10%). Seventy three (73%) of the patients in this study had complete response and in 7% pleurodesis failed whilst 20% has partial response. In the povidone group the success rate was 93.4% and in the tetracycline group was 93.3% with a p-value of 0.716. There was no statistical difference in the responses based on the agents used. Conclusion malignant pleural effusion is a devastating condition as it heralds the end-of-life processes of a primary malignancy. Povidone iodine is a safe, cheap, effective, widely available and effective pleurodesing agent for use in patients with malignant pleural effusion.

Transthoracic sonographic scores in evaluating the success of different scelerosing modalities in patients with malignant pleural effusion

“…Omoregbee and Okugbo [40] found that iodopovidine was effective as tetracycline for pleurodesis in patients with MPE with an overall success rate of 93.4% and 93.3%, respectively.…”

Does hyperthermic povidone-iodine lavage increase the apoptotic rate of residual cancer cell in patients with malignant pleural mesothelioma?—a prospective pilot study

“…The use of povidone-iodine in inducing apoptosis has largely been described in, in vitro studies, however povidone-iodine has also been described as a safe alternative in chemical pleurodesis in the context of malignant pleural effusions, with results comparable to cisplatin ( 12 ), gemcitabine ( 14 ), bleomycin ( 19 , 20 ), tetracycline ( 21 ), and talc ( 22 , 23 ). In vitro studies have shown povidone-iodine to have no effect on apoptosis proteins expressed on MPM cells, however it inhibits cell growth ( 6 ), and exhibits a necrotic rather than apoptotic mechanism of cell death ( 24 ).…”

Comparison of the Effectiveness between Povidone-Iodine and Bleomycin as Pleurodesis Agents in Patients with Malignant Pleural Effusion at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia

“…There was no significant difference. [9][10][11][12] One of the successes of pleurodesis is determined by the type of sclerosant 3224 used. Various substances have been reported to have been used as pleurodesis agents, including talc, oxytetracycline, quinacrine, bleomycin, mitomycin, and povidone-iodine.…”