TALC PLEURODESIS IN RECURRENT PLEURAL EFFUSIONS

Background and aims: The treatment of recurrent malignant pleural effu sions is known to be difficult and varies from observation in asymptom atic patients to pleurectomy with varying results. This prospective st udy presents the efficacy and the limits of iodized talc pleurodesis i n patients with malignant and non-malignant recurrent pleural effusion s. Methods: In a prospective trial talc pleurodesis was performed in 5 0 patients with recurrent pleural effusions (malignant effusions: n=36 , non-malignant effusions: n = 14). After insertion of a chest tube an d complete re-expansion of the lung, 5 mg of talc and 3 mg of thymol i odine were installed with 0.5 mi of 1 % xylocaine/kg body weight and 3 0 mi 0.9% saline solution. The chest tube was removed after an average time of 3 days and chest radiographs were performed 1 month after ins tillation to evaluate the efficacy of pleurodesis. Results: Successful therapy was achieved in 31 of 33 patients (94%) with malignant effusi ons within a follow-up period of 7 months. Three patients died within 1 month after therapy due to progressive malignant disease. The treatm ent was successful in all cases of non-malignant effusions and complic ations did not occur in either group. Conclusions: These results indic ate that pleurodesis with iodized talcum slurry is a simple and inexpe nsive method with high efficacy in controlling malignant and non-malig nant pleural effusions.