[Intrapleural talc in malignant pleural effusions (author's transl)].

Intrapleural talc poudrage was carried out at the end of thoracoscopy in 77 patients after complete aspiration of fluid with uniform insufflation over the whole surface area of the pleura of 4 to 5 ml of pure talc, asbestos free. A continuous suction drain was left in place for 3 to 6 days. Amongst these patients, there were 57 cases of pleural effusion due to metastases and 20 mesotheliomas. A satisfactory result was obtained in 70 patients (91%). There were 7 failures. Fourteen mesotheliomas in which talc was used were compared with 14 further cases operated upon by pleurectomy. Both series were compared retrospectively in terms of age, sex, exposure to asbestos, histological type and the interval between the first symptom and treatment. In the talc series, there were 11 excellent results, 2 moderate and 1 nil. In the operated series there were 10 excellent results, 1 nil and 3 postoperative deaths. Survival of the patients was 395 +/- 55 days after the application of talc and 315 +/- 65 days after pleurectomy. There was thus a slight benefit in favour of the talc technique but this was not statistically significant. A figure of approximately 90% of satisfactory results is found in other series of the use of intrapleural talc published. This technique is thus effective and free of danger, and may be used in malignant effusions when techniques of local instillation of various substances and systemic chemotherapy have failed.