[Pleurodesis with tetracycline hydrochloride]

Malignant pleural effusion is a common complication of malignant disease requiring drainage and palliative sclerosing therapy in the vast majority of cases. Tetracycline in conjunction with thoracoscopic drainage is currently considered as the optimal sclerosing agent due to its high efficacy, good patient tolerance, simple and repeatable applicability and low cost of treatment. Traditional and more recent agents like fibrin-sealant may give similar results, but do not achieve a favourable all-round-properties. The relevant data from the literature are reviewed, our own results are presented. An explicit description of pleurodesis is given, also a brief discussion of possible mechanisms of action of sclerosing agents. Concepts are suggested for positioning pleurodesis in the general therapeutic approach to various tumours. The concept of pleurodesis can be similarly successful and safely applied on malignant pericardial effusion (pericardesis).