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Ten patients with malignant pleural effusion secondary to spread from underlying bronchogenic carcinoma were treated with intrapleural instillation of tetracycline and thoracostomy drainage. The procedure prevented reaccumulation of fluid in the pleural space in six patients over six months follow-up and two patients who died in three months from progress of the underlying disease did not demonstrate reaccumulation of fluid during that period. In two patients the treatment failed to prevent reaccumulation of fluid. The procedure is safe, simple and effective (80%) and can be carried out in any hospital. Tetracycline acts as an effective sclerosing agent to bring about pleural symphysis.
