Comparison between Tranexamic acid and Doxycycline Pleurodesis in Malignant Pleural effusion by Medical Thoracoscopy

Abdalla, Hytham; Shalan, Ibraim; Darwish, Kamal; Haleima, Kahalid; AbdElrahman, Montaser

doi:10.21608/ejhm.2023.296753

Comparison between Tranexamic acid and Doxycycline Pleurodesis in Malignant Pleural effusion by Medical Thoracoscopy

Document Type : Original Article

Authors

10.21608/ejhm.2023.296753

Abstract

Background: Malignant pleural effusion (MPE) is a morbid disability that places a major strain on the healthcare system. For MPE, pleurodesis and indwelling pleural catheters continue to be standard treatments.
Objective: The aim of the current study was to compare thoracoscopic pleurodesis with tranexamic acid and doxycycline powder as palliative preventative therapies for recurring malignant pleural effusions in terms of effectiveness, safety, and prognosis. Patients and methods: A randomized controlled clinical trial included 100 patients with MPE who were divided into 2 groups: Group (I) included 50 patients with thoracoscopic pleurodesis of tranexamic acid and Group (II) included 50 patients with thoracoscopic pleurodesis of doxycycline powder. All patients had their history checked, clinical assessment, pleural fluid laboratory investigations (total proteins, LDH, Differential cell count, cytology for malignant cells, PH, Glucose level, culture and sensitivity, and Adenosine Deaminase (ADA)), chest radiograph, chest ultrasound, computed tomography (CT) scan of the chest, and thoracoscopic pleurodesis.
Results: There was no significant difference between the groups in terms of Light’s criteria and lymphocytes (%) in the pleural fluid. However, there was a significant difference between groups regarding Chest x ray at 3^rd month and Chest ultrasound at 3^rd month. Success of pleurodesis was higher in the Tranexamic acid group (95.5%) compared to the Doxycycline group (81%) with statistically significant difference (P=0.047). Conclusion: Medical thoracoscopy is a safe, easy and efficient way to diagnose the malignant pleural effusion as well as performing pleurodesis. Tranexamic acid has a great benefit in pleurodesis with no chest pain during and after pleurodesis and has a higher success rate than doxycycline for pleurodesis.

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