A comparison of the effectiveness of talc, polidocanol and ethanol as pleural sclerosing agents in rabbits

Abstract

Background: Aim of the study was to compare the pleurodesis results from the intrapleural injection of talc, polidocanol and ethanol into the rabbit pleura.

Methods: Twenty-nine New Zealand white rabbits were randomized into three groups for the intrapleural administration of 200 mg/kg (n = 10) of talc, 15 mg/kg (n = 10) of 3 % polidocanol or 1 mL (n = 9) of 4.2 % ethanol in 2 mL saline solution, respectively. The pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of inflammation, thickness, cellularity, neovascularity and mesothelial cell proliferation in both pleura.

Results: The mean degrees of gross pleurodesis were 2.0 +/- 0.66 (on a scale from 0 to 4) for talc, 2.2 +/- 0.91 for polidocanol and 0.7 +/- 0.86 for ethanol. The parietal pleura thickness was 191 +/- 213.6 microm, 236 +/- 224.6 microm and 45 +/- 44.2 microm, while the visceral pleura thickness was 109 +/- 103.7 microm, 164 +/- 161.4 microm and 48 +/- 42.2 microm in the talc, polidocanol and ethanol groups, respectively. The results of microscopic examination were similar in the talc and polidocanol groups.

Conclusion: The intrapleural injection of polidocanol produces better pleurodesis than does the intrapleural injection of talc or ethanol in rabbits. Because of the efficacy of polidocanol as a sclerosing agent, its use in humans should be considered after further animal studies.