Thoracoscopic talc poudrage pleurodesis for malignant effusions. A review of 360 cases.

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 life-long 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.