Format

Send to

Choose Destination
Lancet. 2007 May 5;369(9572):1535-1539. doi: 10.1016/S0140-6736(07)60708-9.

Safety of pleurodesis with talc poudrage in malignant pleural effusion: a prospective cohort study.

Author information

1
Canisius Wilhelmina Hospital, Nijmegen, Netherlands. Electronic address: j.janssen@cwz.nl.
2
Canisius Wilhelmina Hospital, Nijmegen, Netherlands.
3
Hôpital Sainte-Marguerite, Marseille, France.
4
Spedali Civili, Brescia, Italy.
5
University Hospital UZ Brussels, Brussels, Belgium.
6
Hospital Universitario Virgen del Rocio Sevilla, Seville, Spain.
7
Lungenklinik Heckeshorn, Berlin, Germany.
8
Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
9
Azienda Ospedali Riuniti, Ancona, Italy.
10
Centre Hospitalier Régional Universitaire Lille, Lille, France.
11
Johanniter-Krankenhaus, Treuenbrietzen, Germany.
12
University Hospital of Heraklion, Heraklion, Crete, Greece.
13
St. Elisabeth Ziekenhuis, Turnhout, Belgium.
14
Tygerberg Academic Hospital, Cape Town, South Africa.
15
Centre Valaisan de Pneumologie, Montana, Switzerland.

Abstract

BACKGROUND:

Talc is the most effective chemical pleurodesis agent for patients with malignant pleural effusion. However, concerns have arisen about the safety of intrapleural application of talc, after reports of development of acute respiratory distress syndrome in 1-9% of treated patients. Our aim was to establish whether use of large-particle-size talc is safe in patients with malignant pleural effusion.

METHODS:

We did a multicentre, open-label, prospective cohort study of 558 patients with malignant pleural effusion who underwent thoracoscopy and talc poudrage with 4 g of calibrated French large-particle talc in 13 European hospitals, and one in South Africa. The primary endpoint was the occurrence of acute respiratory distress syndrome after talc pleurodesis.

FINDINGS:

No patients developed acute respiratory distress syndrome (frequency 0%, one-sided 95% CI 0-0.54%). 11 (2%) patients died within 30 days. Additionally, seven patients had non-fatal post-thoracoscopy complications (1.2%), including one case of respiratory failure due to unexplained bilateral pneumothorax.

INTERPRETATION:

Use of large-particle talc for pleurodesis in malignant pleural effusion is safe, and not associated with the development of acute respiratory distress syndrome.

PMID:
17482984
DOI:
10.1016/S0140-6736(07)60708-9
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center