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 mu m 236 +/-224.6 mu m and 45 +/- 44.2 mu m, while the visceral pleura thickness was 109 +/-103.7 mu m, 164 +/- 161.4 mu m and 48 +/- 42.2 mu m 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.