Original articleGeneral thoracicWho Gains Most? A 10-Year Experience With 611 Thoracoscopic Talc Pleurodeses
Section snippets
Patients and Methods
The study was approved by the Ethics Committee of the University of Tübingen. According to the Ethics Committee, individual consent was not necessary because of the study’s retrospective design.
Study Population
A total of 611 patients (295 women, 316 men) with one-sided pleural effusion received thoracoscopic talc pleurodesis. Of these, 543 patients (88.9%) had malignant disease. After talc pleurodesis, 492 (80.5%) had a fully expanded lung, 451 (89.1%) had improvement in symptoms, and a recurrent pleural effusion developed in 135 (22.1%). A total of 105 patients (20.7%) died within the first 30 postoperative days, and 347 (68.6%) had a successful pleurodesis according to the criteria mentioned above.
Comment
Malignancy is the most common cause of pleural effusion. The estimated number of patients with malignant pleural effusion may be as high as 100 per 100,000 population. This high incidence makes malignant pleural effusion a serious problem for health care institutions. Curative treatment in metastatic disease is usually impossible when the pleura are involved; thus, the goal of treatment for these patients is improvement in symptoms that worsen the quality of life.
Several methods have been
References (45)
- et al.
A comparison of thoracoscopic talc insufflation, slurry, and mechanical abrasion pleurodesis
Chest
(1997) - et al.
Prospective randomized trial of talc slurry vs bleomycin in pleurodesis for symptomatic malignant pleural effusions
Chest
(1997) - et al.
Outpatient pleurodesis of malignant pleural effusions using a small-bore pigtail catheter
Chest
(2000) - et al.
Video-assisted thoracoscopic pleurectomy in the management of malignant pleural effusion
Chest
(1995) - et al.
Treatment of malignant pleural effusion: pleurodesis using a small percutaneous catheterA prospective randomized study
Respir Med
(1998) - et al.
Clinical efficacy of doxycycline for pleurodesis
Chest
(1994) - et al.
Thoracoscopy talc poudrage: a 15-year experience
Chest
(2001) - et al.
Predicting survival in patients with recurrent symptomatic malignant pleural effusions: an assessment of the prognostic values of physiologic, morphologic, and quality of life measures of extent of disease
Chest
(2000) - et al.
Phase III intergroup study of talc poudrage vs talc slurry sclerosis for malignant pleural effusion
Chest
(2005) - et al.
Efficacy and safety of iodopovidone in chemical pleurodesis: a meta-analysis of observational studies
Respir Med
(2006)
Prospective randomized comparison of thoracoscopic talc poudrage under local anesthesia versus bleomycin instillation for pleurodesis in malignant pleural effusions
Am J Respir Crit Care Med
Optimal pleurodesis: a comparison study
Ann Thorac Surg
The use of the nitrogen mustards in the palliative treatment of carcinomaWith particular reference to bronchogenic carcinoma
Cancer
Malignant pleural effusions: treatment with small-bore-catheter thoracostomy and talc pleurodesis
Radiology
Combined intrapleural and intravenous chemotherapy, and pulmonary irradiation, for treatment of patients with lung cancer presenting with malignant pleural effusionA pilot study
Oncology
Pleurodesis in patients with malignant pleural effusions: talc slurry or bleomycin? Results of a prospective randomized trial
World J Surg
The role of surgery in diagnosis and treatment of malignant pleural mesothelioma
Curr Opin Oncol
Prospective randomized trial of intrapleural bleomycin versus interferon alfa-2b via ultrasound-guided small-bore chest tube in the palliative treatment of malignant pleural effusions
J Clin Oncol
The effects of intrapleural polyclonal anti-tumor necrosis factor alpha (TNF alpha) Fab fragments on pleurodesis in rabbits
Lung
Comparing transforming growth factor-beta2, talc and bleomycin as pleurodesing agents in sheep
Respirology
Pleural poudrage
J Thoracic Surgery
Pleural macrophages differentially alter mesothelial cell growth and collagen production
Inflammation
Cited by (56)
Gender Disparity in Referral for Definitive Care of Malignant Pleural Effusions
2019, Journal of Surgical ResearchMalignancy-Related Effusions
2019, Abeloff’s Clinical OncologyDiagnosis and Management of Pleural Transudates
2017, Archivos de BronconeumologiaMalignant Effusions
2013, Abeloff's Clinical Oncology: Fifth EditionBilateral transudative effusions
2023, Challenging Cases in Pleural Diseases