Pleurodesis with Thulium Cyber Laser versus talc poudrage: a comparative experimental study

Area of Science:

• Thoracic Surgery
• Pulmonology
• Medical Devices

Background:

• Pleurodesis is crucial for managing pleural effusions.
• Sclerosing fluids are standard for bedside procedures, but thoracoscopic options are evolving.
• Thulium Cyber Laser (TCL) presents a novel approach for pleurodesis during thoracoscopy.

Purpose of the Study:

• To compare the efficacy and predictability of Thulium Cyber Laser (TCL) photoevaporation with traditional talc poudrage for pleurodesis.
• To evaluate the quality, location, and inflammatory response of pleurodesis induced by TCL versus talc.

Main Methods:

• Twenty pigs underwent videothoracoscopy (VATS).
• Ten pigs received TCL parietal pleura photoevaporation (150W, 2010nm) on the posterior ribs.
• Ten pigs underwent talc poudrage (1g/18kg) via uniportal thoracoscopy.

Main Results:

• TCL achieved firm (7/10) or moderate (3/10) pleurodesis in all models.
• Talc resulted in firm (4/10) or moderate (6/10) pleurodesis.
• TCL produced localized adhesions exclusively in the treated area with predictable outcomes (10/10).
• Talc caused broader, often jagged adhesions and more severe inflammation.
• Talc was less effective for apico-dorsal pleurodesis (2/10).

Conclusions:

• Thulium Cyber Laser (TCL) photoevaporation is a viable and effective method for thoracoscopic pleurodesis.
• TCL offers more homogeneous, predictable, and localized pleural adhesions compared to talc poudrage.
• TCL appears to induce a less aggressive inflammatory response than talc.