Abstract
Introduction: Talc pleurodesis is an excellent therapeutic option in patients with malignant pleural effusions (MPE), however the best method to perform it remains a matter of debate.
Objectives: To compare two different methods of talc instillation in terms of clinical efficacy and safety in patients with MPE.
Methods: Retrospective study of patients with MPE submitted to talc pleurodesis between 2006 and 2010. Two different techniques were compared: thoracoscopic talc poudrage (TP) and talc slurry through the chest tube (TS).
Results: A total of 93 patients were evaluated (47 TP group, 46 TS group). Clinical demographics and primary malignancies were similar in both groups. The overall complication rate was 54,8%, without significant difference between the two groups. Most frequent complications were thoracic pain (32,3%), fever (24,7%), subcutaneous emphysema (7,5%) and prolonged drainage (5,4%). No serious complication or death was registered. The average length of hospital stay was 8 days in the TP group vs 19,7 days in the TS group (p=0,001). The average chest drain and suction duration was 5,6 days in the TP group vs 10 days in the TS group (p=0,001). Among patients alive at 30 days, efficacy in local control of MPE was 82,5% in the TP group (33/40) vs 72,1% in the TS group (31/43) (p=0,259). There was no difference in mortality between the two groups (p=0,336).
Conclusions: Talc pleurodesis was a safe and effective palliative treatment for patients with MPEs. Patients who underwent thoracoscopic talc poudrage had a significant shorter length of hospital stay and chest drainage duration. There was no difference regarding complications, efficacy and mortality.
- © 2012 ERS
