Comparison between combining bleomycin and tranexamic acid solution versus thoracoscopic talc poudrage in pleurodesis of malignant pleural effusion

Background Malignancy is a well-known etiology of exudative pleural effusion and unfortunately, malignant pleural effusion (MPE) is characterized by high recurrence hence, the patient becomes upset mainly from progressive dyspnea until occurring at rest and indeed, this impairs the quality of life enforcing the patient to frequently seek medical advice to exterminate the problem and prevent or significantly decrease the recurrence Aim The current study aims to compare pleurodesis by a combination of bleomycin and tranexamic acid solution via chest tube instillation and medical thoracoscopic talc poudrage in MPE. Patients and methods A randomized controlled clinical trial included 60 patients with MPE, eligible for pleurodesis, who were divided into two groups: group I included 30 patients who underwent medical thoracoscopic pleurodesis by talc powder and group II included 30 patients who underwent pleurodesis by bleomycin–tranexamic acid combination through injection into siliconized intercostal tube 26 F. Results There was no significant difference between the two groups regarding dyspnea scale improvement and hospital stay, but talc poudrage had a higher success rate than bleomycin–tranexamic acid solution regarding the recurrence. Conclusion The combination of bleomycin–tranexamic acid mixture is comparable to talc powder regarding the improvement of dyspnea and postprocedure hospital stay days.