Management of malignant pleural effusions by talc pleurodesis.

Since July 2002, the Cardiothoracic Surgical team started talc pleurodesis with or without surgical assisted video thorascopy. This paper reports a retrospective review of medical records of 6 patients who received talc pleurodesis from July 2002 to March 2003, three males and three females. The primary malignancy was proven histological in five patients. All the six patients presented with dyspnoea. Two patients received thoracocentesis 2 or 3 times while 4 had formal chest drains till pleurodesis. The total amount of fluid drained before pleurodesis ranged from 2 to 7 litres. One patient died from metastasis 1 month after pleurodesis with a Blake drain in situ. The pleurodesis success rate was 100% for the 5 patients that lived. All the patients had MPE as a consequence of metastatic malignancy. The patients were discharged home after pleurodesis with a Blake drain and grenade. The complete pleurodesis rate was 5/5. Pain was the most common complication of tetracycline and doxycycline pleurodesis. Talc pleurodesis is a relatively cheap and safe procedure undertaken at Cardiothoracic Surgical Unit, Christchurch Public Hospital. Chemical pleurodesis using talc is an important consideration.