Comparison of Hydroxyethyl starch 130/0.4 (6%) with commonly used agents in an experimental Pleurodesis model
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RESEARCH ARTICLE
Open Access
Comparison of Hydroxyethyl starch 130/0.4 (6%) with commonly used agents in an experimental Pleurodesis model Hasan Oğuz Kapicibasi1* , Hasan Ali Kiraz2
and Nazli Demir Gök3
Abstract Background: Hydroxyethyl Starch (HES) 130/0.4 (6%) is a commonly used intravascular volume expander with antiinflammatory and antioxidant properties. In this study, we aimed to compare the histopathologic activity of HES 130/0.4 (6%) with various widely-used agents in pleurodesis. Methods: Forty male Wistar-Albino rats were divided into five groups: controls, povidone-iodine recipients (PI group), sterile talcum recipients (Talcum group), autologous blood recipients (AB group) and HES 130/0.4 (6%) recipients (HES group). Thirty days after application of agents, pleural and lung tissues were resected. Evaluation was performed via macroscopic scoring (adhesion) and specimens were stained with H&E for microscopic examination (inflammation and fibrosis). Results: HES recipients had significantly higher adhesion compared to controls (lower grade 0, higher grade 1 frequency vs. controls), they were found to have significantly lower frequency of grade 2 adhesion (vs. PI, Talc and AB) and grade 3 adhesion (vs. AB), indicating that the adhesion-generating properties of HES were only superior to the control group. HES recipients had significantly higher inflammatory grades compared to controls (lower grade 0, higher grade 1 frequency), while they had lower grades compared to the PI, Talc and AB groups. Although the PI, Talc and AB groups were statistically similar in most comparisons, we observed a trend towards higher success with the use of Talc and especially AB. Conclusion: Our results do not support a role for HES in pleurodesis. We believe that the autologous blood method remains as an effective and successful procedure without side effects. Keywords: Parietal-visceral pleura, Pleurodesis, Hydroxyethyl starch
Background Pleurodesis is a procedure in which the anatomical space between the parietal and visceral pleura is removed by the adhesion of these two layers. While adhesion can be achieved mechanically by abrasion via thoracoscopy or thoracotomy, chemical pleurodesis is very common with the application of an agent via thoracoscopy and chest * Correspondence: [email protected] 1 Department of Thoracic Surgery, Canakkale Onsekiz Mart University, Faculty of Medicine, Canakkale, Turkey Full list of author information is available at the end of the article
tube insertion. The most frequently used agent in the latter approach to pleurodesis is talcum powder, also known as talc [1]. However, when the research concerning pleurodesis methods is evaluated, it is evident that there is no “ideal” agent for pleurodesis [2], and success rates with different agents vary greatly, from 54 to 93% [3]. An ideal agent for chemical pleurodesis should be easy to apply, effective, accessible, inexpensive and must have minimal side effects. Due to these prerequisites, the literature has focused on the use of autolog
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