Abstract:
Introduction: Pleural effusion occurs when fluid accumulates
in the space between the parietal and visceral pleurae. It results either from increased production or decreased absorption of the fluid. It can arise from malignant or benign causes.
The treatment for pleural effusions caused by malignant diseases is mainly palliative, with pleurodesis being the most frequently employed therapeutic method. The usage of chemical
agents in pleurodesis causes inflammation which leads to adhesion of the pleural membranes.
The aim of the study was to analyze the inflammatory effect
of hydrogen peroxide (H2O2) as a pleurodesis agent.
Material and methods: The experimental study was conducted on 10 male New Zealand rabbits. In order to reduce
the number of animals used in the experiment, both hemithoraces of the rabbits were used for pleurodesis. We divided
the rabbits into two groups. In the first group, talc solution prepared in 0.9% saline was applied to the pleural cavities of both
hemithoraces of 5 rabbits (a total of 10 pleural cavities), and,
in the second group, a 3% hydrogen peroxide (H2O2) solution
prepared in 0.9% saline was applied to the pleural cavities of
both hemithoraces of 5 rabbits (a total of 10 pleural cavities).
Results: Blind macroscopic and microscopic examinations
were carried out by a single pathologist using the scoring
technique by Kaya et al. In macroscopic evaluation, grade 1
adhesion was found in the H2O2 group only. Grade 2 adhesion was achieved in 4 pleural cavities in the H2O2 group and
4 cases in the talc group. Grade 3 adhesion occurred in 3 cases
in the H2O2 group and 6 cases in the talc group. In microscopic
examination, grade 1 adhesion took place in the H2O2 group
only. Grade 2 adhesion was achieved in 4 cases in the H2O2
group and 1 case in the talc group. Grade 3 adhesion was
found to be similar in both groups. On the other hand, talc
was found to be superior to hydrogen peroxide in terms of
providing grade 4 adhesion.
Conclusions: It was determined that the use of talc in pleural
cavities resulted in better grades of adhesion; however, H2O2
was found to diffuse more homogeneously. H2O2 is a chemical
agent that has similar effects to talc in terms of pleurodesis, but demonstrates better diffusion on the pleural surfaces. It is
also inexpensive, accessible, and easy to administer.
