Evaluation of Trombovar as a new candidate for pleurodesis

Background: Malignant pleural effusion which commonly caused by breast and lung carcinoma or lymphoma declines the patient’s quality of life and it is a sign of poorprognosis in these patients. Pleurodesis, a medical procedure of artificially obliterate the pleural space by adhesion of two pleural layer is used to ameliorate the signs and severity of malignant pleaural effusion. Common compounds that are in use for pleurodesis are talk, deoxycyclin and bleomycin which have their own limitations including adverse sideeffects, unavailability in Iran pharmaceutical market and cost prohibitive, respectively. So we designed this study to evaluate a new candidate Trombovar (Sodium Tetradecyl Sulfate) which is currently in use for esophageal or lower limb Varicos veins, internal hemorrhoids and compare its performance with Talc slurry and Bleomycin in a rat model.Objectives: Compare the effectiveness of Trombovar as a novel choice with Talc and Bleomycin in producing pleurodesis in wistar rats.Materials and Methods: 12-week-old male, rats weighing 225 to 320g were randomly divided into four equal groups (n:36) treated with Bleomycin, Talc slurry, Trombovar, ornormal saline using a 5 Fr Silastic tube in right pleural space. After 30 days the rats were euthanized and the pleural spaces were evaluated macroscopically and microscopically for mesothelial cell hyperplasia, signs of heamoragia and chronic inflammation by two independent pathologists.Results: Masson trichrome staining was used on the visceral pleura sections. In the control group eight rats showed minimal collagen deposition, while only one (11.1%) hadmoderate collagen deposition. In the Trombovar group, three rats (33.33%) with moderate and three ones (33.33%) with severe fibrosis was observed. In the talc group, five rats(55.5%) showed moderate fibrosis and one (12.2%) had severe fibrosis. In the bleomycin group, seven (78%) and two (22%) rats respectively showed moderate and severe fibrosis.Overally, Bleomycin caused the most severe fibrosis and Trombovar was in the second place, both were significantly different from the control group (P=0.017). The highest rateof chronic inflammation was seen in Trombovar treated group (P=0.034).Conclusion: It can be concluded that Trombovar is a good candidate for use in pleurodesis and merit further investigations for determining possible adverse effects

کلیدواژه ها:

Pleurodesis ، Pleural effusion ، Bleomycin ، Trombovar ، Talc