Chemical pleurodesis with betadine, easy, inexpensive and well tolerated in cases of pneumothorax and metastatic pleural effusions

<bold>Introduction:</bold> Chronic or recurrent pneumothorax and metastatic pleurisy are serious concerns prompting the search for a less invasive and inexpensive therapeutic means to create a symphysis. We report on the effectiveness of chemical pleurodesis with betadine at 10% over 4 years. <bold>Materials and method:</bold> This chemical pleurodesis with betadine was indicated in cases of chronic pneumothorax more than 10 days or after 2 recurrences in 24 cases and in cases of recurrent metastatic pleural effusions in 14 cases. It consists of instilling a solution of 10% betadine, xylocaine and saline through a pleural drain. The solution is maintained intrapleurally for 2 hours then aspirated. This technique was a success with an effectiveness of around 90% in cases of pneumothorax. 75% benefited from a single instillation and 25% after 2 instillations. Lung expansion noted between the 2nd and 5th day. No recurrence of pneumothorax with a follow-up of 4 years at 33.33%, 2 years in 52.38% and 1 year at 14.28%. Concerning metastatic pleurisy, drying of the fluid after a single instillation was noted in 83.33%. Local infectious complications were noted in 4 cases. Good tolerance apart from local pain of variable intensity in all pneumothoraxes while it is absent in cases of metastatic pleurisy. <bold>Conclusion:</bold> The effectiveness, safety and good tolerance of this chemical pleurodesis is promising for the future. This technique represents an interesting alternative to chemical pleurodesis with a lower cost of care compared to intrapleural instillation of talc.