Thoracoscopic Talc Poudrage Pleurodesis for Malignant Pleural Effusions

Abstract

The aim of our study was to review the common causes of malignant pleural effusion and to examine the effectiveness of different kinds of pleurodesis that were applied. We made a retrospective study on 79 cases that were hospitalized between January 1998 and July 2003 with recurrent pleural effusions in the Thoracic Surgery Department of Kantonspital Luzern. In the study group, the females were 57.88%; 54.38% of all were smokers; the mean age was 62.14; 78.94% of cases had atypical cells in fluid, and the rest were with biopsy confirmation. The most common causes of malignant pleural fluid were lung and breast cancer. In 57 cases, talc pleurodesis was done; 5 of these were made after bleomycin. The pleurodesis was done in the first 4 days, and the median hospitalization after intervention was 6 days. Complications occurred in 12 cases: pulmonary emboli, pulmonary oedema, pneumonia, empyema, and an increase in pleural drainage. A prognosis of these patients with recurrent chronic pleural effusion is poor, with 5 (8.77%) deaths in the first month and another 5 (8.77%) in the next 6 months, with an important decrease in quality of life. In our study, the success rate was 78.94% and the inefficient repeated thoracocentesis with the increase of liquid between one and three days was associated with a high risk of empyema and decreased the lifespan by less than one month.