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Long-term follow-up of thoracoscopic talc pleurodesis for primary spontaneous pneumothorax

Division of General Internal Medicine, Dept of Internal Medicine, New York University School of Medicine, New York, NY, USA.

To the Editors:

I read with interest the study by Györik et al. 1 of talc pleurodesis for primary spontaneous pneumothorax. The results were not surprising as they confirm previous studies. What was surprising, however, was the lack of a control group, the lack of an intention-to-treat analysis and the failure of the paper's discussion to mention these absences as a weakness.

The authors report a 95% long-term success rate for talc pleurodesis, which represents 53 out of 56 patients initially treated successfully with the technique. There were, however, 112 patients who underwent the procedure. The authors were only able to contact 63 of them; the remaining 49 apparently were not contactable because of "geographical movement."

I am troubled that an intention-to-treat analysis is not reported. Given the 53 long-term successes and 112 original treatments, I arrive at a success rate of 47%, which is half of what the authors report. Together with the lack of a control group of patients who suffered spontaneous pneumothoraces but did not undergo talc pleurodesis, I find it unclear as to what can be reliably concluded from this study.

REFERENCES

1. Györik S, Erni S, Studler U, Hodek-Wuerz R, Tamm M, Chhajed PN. Long-term follow-up of thoracoscopic talc pleurodesis for primary spontaneous pneumothorax. Eur Respir J 2007;29:757–760.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Oransky, I. Search for Related Content PubMed PubMed Citation Articles by Oransky, I.