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Ann Intern Med. 1991 Nov 15;115(10):778-82.

Thoracoscopic talc poudrage pleurodesis for chronic recurrent pleural effusions.

Author information

1
Department of Internal Medicine, Southern California Permanente Medical Group, Harbor City 90710.

Abstract

OBJECTIVE:

To assess the effectiveness of thoracoscopic talc poudrage for the treatment of chronic pleural effusions.

DESIGN:

Prospective evaluation.

SETTING:

Kaiser-Permanente Hospital.

PATIENTS:

Forty-seven consecutive patients with recalcitrant pleural effusions, referred for thoracoscopy.

INTERVENTION:

Patients received general or local anesthesia; 42 had a 7-mm rigid thoracoscopic examination followed by insufflation of 5 mL of talc. Patients then had chest-tube drainage.

MEASUREMENTS:

We recorded clinical characteristics, final diagnosis, procedure-related pain and morbidity, days of hospitalization, patient-reported degree of symptom relief, and chest roentgenographic results at 1, 3, and 12 months. All patients were followed for 16 months or until death.

MAIN RESULTS:

Of 39 evaluable patients, all reported prolonged relief of effusion-related dyspnea. Radiographic results confirmed the elimination of pleural effusions in 34 patients (87%), including all 11 with benign conditions and 23 of 28 (82%) with malignancies. Treatment failed in three patients because of entrapped lung and in two patients with mesotheliomas whose effusions recurred more than a year after treatment. No procedure-related mortality or morbidity was found. Ambulatory patients required hospitalization for a mean of 3.9 days (range, 2 to 11 days). Mild pain was reported by some patients. The mean duration of chest-tube drainage was 2.7 days (range, 1 to 9 days). Patients with malignant disease lived an average of 12.4 months (range, 1 to 61 months) after the procedure.

CONCLUSIONS:

Thoracoscopic talc poudrage is an effective pleural sclerosing technique and is relatively painless.

PMID:
1929026
DOI:
10.7326/0003-4819-115-10-778
[Indexed for MEDLINE]

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