Özgür KÜLAHCI, İsa DÖNGEL, Sami CERAN, Güven Sadi SUNAM

A comparison of the efficacies of heterologous blood, rifamycin, and talc as pleural sclerosants in rabbits: An experimental study

Amaç: Bu çalışmada tavşanlarda rifamisin plörodezis etkinliği araştırıldı. Çalışma planı: Çalışmada ortalama ağırlıkları 3433 g olan toplam 21 adet erkek Yeni Zelanda türü albino tavşan kullanıldı. Bir adet tavşan kan temininde kullanıldı. Diğer 20 tavşan kontrol grubu, heterolog kan grubu, rifamisin grubu ve talk grubu olarak dört gruba ayrıldı. Tavşanlara gruplarına göre sol hemitoraksa takılan kateterden distile su, heterolog taze kan, rifamisin ve steril sıvı talk verildi. Yirmi sekizinci günde tavşanlar yüksek doz anestezi ile sakrifiye edildi. Plevrada makroskopik olarak plörodezis varlığı ve mikroskopik olarak plevral kalınlıkları ölçüldü ve inflamasyon ve fibrozis bulguları araştırıldı. Plörodezis derecesi 0’dan 4’e kadar olan skalada değerlendirildi. Bulgular: Makroskopik ve mikroskopik seviyede kontrol grubu ile heterolog kan grubu arasında istatistiksel olarak a nlamlı fark bulunmadı (p>0.05). Talk ve rifamisin grubunda plörodezis derecesi kontrol ve heterolog kan grubundan daha yüksek idi (p=0.04). Rifamisin grubu ile talk grubu arasında makroskopik ve mikroskopik incelemede anlamlı fark bulunmadı (p>0.05). Plevral fibrozis kalınlığının medyan değerleri kontrol, heterolog kan, rifamisin ve talk grupları için sırasıyla 10 (10-29), 26 (10-71), 312 (264-351) ve 304 (238-331) μm ölçüldü. Sonuç: Tavşanlarda rifamisin plörodezis etkinliği mikroskopik ve makroskopik olarak talk grubu ile benzer; kontrol ve heterolog kan grubuna göre daha üstün bulundu.

Tavşanlarda plevral sklerozan ajan olarak heterolog kan, rifamisin ve talk’ın etkinliğinin karşılaştırılması: Deneysel çalışma

Background: In this study, we aimed to investigate the efficacy of rifamycin pleurodesis in rabbits. Methods: A total of 21 male New Zealand-type albino rabbits with an average weight of 3433 grams, were used in the study. One rabbit was used for blood supply. The other 20 rabbits were divided into four groups, including the control group, the heterologous blood group, the rifamycin group, and the talc group. Distilled water, heterologous fresh blood, rifamycin, and sterile liquid talc were administered through the catheter to the left hemithorax of rabbits. The rabbits were sacrificed using high-dose anesthesia on day 28. The pleural spaces were grossly assessed for evidence of pleurodesis and microscopic thickness of the pleura, and evidence of inflammation and fibrosis were examined. The degree of pleurodesis was rated on a scale of 0 to 4. Results: No statistically significant differences were observed between the control and heterologous blood groups at the macroscopic and microscopic level (p>0.05). The degree of pleurodesis in the talc and rifamycin groups was higher than in the control and heterologous blood group (p=0.04). No significant difference was observed between the talc and rifamycin groups in terms of macroscopic and microscopic examination (p>0.05). The median values of fibrosis thickness of the control, heterologous blood, rifamycin, and talc groups were 10 (10-29), 26 (10-71), 312 (264-351) and 304 (238-331) μm, respectively. Conclusion: The efficacy of rifamycin pleurodesis in rabbits was microscopically and macroscopically similar to the talc group and superior to the control and heterologous blood group.

PDF

___

1. Antony VB, Loddenkemper R, Astoul P, Boutin C, Goldstraw P, Hott J, et al. Management of malignant pleural effusions. Eur Respir J 2001;18:402-19.
2. Schulze M, Boehle AS, Kurdow R, Dohrmann P, Henne- Bruns D. Effective treatment of malignant pleural effusion by minimal invasive thoracic surgery: thoracoscopic talc pleurodesis and pleuroperitoneal shunts in 101 patients. Ann Thorac Surg 2001;71:1809-12.
3. Light RW, Wang NS, Sassoon CS, Gruer SE, Vargas FS. Talc slurry is an effective pleural sclerosant in rabbits. Chest 1995;107:1702-6.
4. Rehse DH, Aye RW, Florence MG. Respiratory failure following talc pleurodesis. Am J Surg 1999;177:437-40.
5. Hunt I, Barber B, Southon R, Treasure T. Is talc pleurodesis safe for young patients following primary spontaneous pneumothorax? Interact Cardiovasc Thorac Surg 2007;6:117-20.
6. Yildirim H, Metintas M, Ucgun I, Erginel S, Alatas F, Kurt E. Talc Plörodezise bağlı gelişen yan etkiler. Osman Gazi Tıp Dergisi 2005;27:51-6.
7. Ahmadzadehfar H, Palmedo H, Strunk H, Biersack HJ, Habibi E, Ezziddin S. False positive 18F-FDG-PET/CT in a patient after talc pleurodesis. Lung Cancer 2007;58:418-21.
8. Bilgin M, Kahraman C, Akcalı Y, Oğuzkaya F. Tekrarlayan primer spontan pnömotoraks tedavisinde otolog kan ile plörodezis. Erciyes Medical Journal 2002; 24: 82-5.
9. Mitchem RE, Herndon BL, Fiorella RM, Molteni A, Battie CN, Reisz GR. Pleurodesis by autologous blood, doxycycline, and talc in a rabbit model. Ann Thorac Surg 1999;67:917-21.
10. Dresler CM, Olak J, Herndon JE 2nd, Richards WG, Scalzetti E, Fleishman SB, et al. Phase III intergroup study of talc poudrage vs talc slurry sclerosis for malignant pleural effusion. Chest 2005;127:909-15.
11. Marchi E, Vargas FS, Acencio MM, Antonangelo L, Teixeira LR, Genofre EH, et al. Talc and silver nitrate induce systemic inflammatory effects during the acute phase of experimental pleurodesis in rabbits. Chest 2004;125:2268-77.
12. Tremblay A, Stather DR, Kelly MM. Effect of repeated administration of low-dose silver nitrate for pleurodesis in a rabbit model. Respirology 2011;16:1070-5. doi: 10.1111/j.1440- 1843.2011.02007.x.
13. Birgül K, Hikmet ÖM, Veral A. Tavşanlarda pleural sklerozan ajan olarak klaritromisin. Turk Toraks Dergisi 2000;1:40-3.
14. Miller Q, Meschter C, Neumaster T, Pratt J, Moulton M, Downey D, et al. Comparison of pleurodesis by erythromycin, talc, doxycycline, and diazepam in a rabbit model. J Surg Educ 2007;64:41-5.
15. Haddad FJ, Younes RN, Gross JL, Deheinzelin D. Pleurodesis in patients with malignant pleural effusions: talc slurry or bleomycin? Results of a prospective randomized trial. World J Surg 2004;28:749-53.