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(Chest. 1996;110:1387-1393.)
© 1996 American College of Chest Physicians

Thoracoscopic Talc Poudrage Pleurodesis for Malignant Effusions

A Review of 360 Cases

Jean-Regis Viallat MD, PhD1; Françoise Rey MD, PhD1; Philippe Astoul MD, FCCP2; and Christian Boutin MD, FCCP2

1 From Paoli-Calmettes Institute, Marseilles, France
2 From La Conception Hospital, Marseilles, France

Objective: To assess the efficacy, permanence, and safety of thoracoscopic talc poudrage (TTP) for pleurodesis in malignant effusions.

Design: Retrospective.

Participants: Patients with lifetime follow-up who received TTP in two related centers in Marseilles, France.

Results: Three hundred sixty patients were included in this study: 88 had mesothelioma and 272 had pleural metastases. The mean follow-up time was 12 months (2 to 120). Of the 327 patients whose response could be evaluated, 90.2% had a successful pleurodesis at 1 month, and 82.1% had a lifelong pleural symphysis. Adverse effects included 1 death 3 days after the procedure in a patient with end-stage disease, fever (9.8%), empyema (2.5%), pulmonary infection (0.8%), and malignant invasion of the scar (1 patient).

Conclusions: TTP is an effective and safe method of lifelong pleurodesis. It should be performed early on in the history of malignant effusions to avoid the risk of respiratory failure, this being directly linked to the general and respiratory status of the patients at the time of the procedure.

Key Words: malignant effusions • mesothelioma • pleurodesis • talc poudrage • thoracoscopy

Submitted on December 20, 1995
Accepted on May 21, 1996




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