A Comparison of the Effectiveness of Talc, Polidocanol and Ethanol as Pleural Sclerosing Agents in Rabbits

Abstract

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