PLEURODESIS USING TALC SLURRY

Objective: To determine the efficacy and safety of talc slurry for ple urodesis. Design: Retrospective. Participants: All patients who receiv ed talc slurry via tube thoracostomy at Memorial Sloan-Kettering Cance r Center from March 1991 to April 1992. Results: Fifty-eight patients received talc slurry in 75 procedures; five patients had 2 unilateral procedures and 12 had bilateral procedures. Fifty-two patients had mal ignant pleural effusions with the most common cell types being breast (23 of 52, 44 percent), lung (4 of 52, 8 percent), ovarian (4 of 52, 8 percent), and endometrial (3 of 52, 6 percent). Four patients had ben ign conditions. The mean duration of follow-up was 171 days (range, 2 to 450 days). Success, defined as the absence of pleural fluid reaccum ulation, was evaluable in 47 of 73 (64 percent) procedures. Pleurodesi s was successful in 38 of 47 (81 percent). Adverse effects associated with pleurodesis included fever (46 of 73, 63 percent), empyema (4 of 73, 5 percent), atrial arrhythmia (3 of 73, 4 percent), hypotension (3 of 73, 4 percent), and hypoxemic respiratory failure (3 of 73, 4 perc ent). There were no deaths attributable to the procedure. Conclusions: Talc slurry instilled through a chest tube is an effective bedside me thod of pleurodesis. Fever occurs frequently. Respiratory failure is a rare but potentially serious complication that deserves further inves tigation.