[Value of talc administration using thoracoscopy in the symptomatic treatment of recurrent pleurisy. Apropos of 302 cases].
From the data of a retrospective study the authors assess the value of pleural symphysis by talc in the symptomatic treatment of recurrent pleural effusion. 300 patients, 254 of whom were suffering from pleural effusion secondary to cancer and 48 of whom had non-cancerous pleural effusion, were subjected to a thoracoscopy under local anaesthetic allowing the instillation of 5-10 mls of talc powder followed by aspiration drainage for 4-8 days. Out of 270 evaluable cases, an immediate positive result (defined as the absence of any recurrence of the pleural effusion at the drainage site) was obtained in 251 cases or 93% +/- 3% (being 92.1% +/- 3.5% of the cases of pleural cancer and 97.7 +/- 4.5% in cases of non-cancerous pleural effusion). At the end of 6 months there was no recurrence of the effusion in 80.6% of cases. There were 19 early failures (7% +/- 3%) and 25 late failures of whom 9 benefitted from a further attempt at a pleural symphysis (either a pleurectomy, or injection of talc in suspension, or new talc therapy by thoracoscopy). On the whole the complications were minor: pain, fever and rarely more serious: empyema in 6 cases and cancerous nodules down the drainage line in 10 cases. There had been 15 deaths (5.3% +/- 2.6%) during the period of drainage in some very weak and fragile patients. Pleural talcage leads to an improvement in dyspnoea in 82% +/- 7.4% of cases and the general condition was improved in 54% +/- 9.8%.(ABSTRACT TRUNCATED AT 250 WORDS)
Boniface
E
E
Service de Pneumologie, Hôpital de la Croix-Rousse, Lyon.
Guérin
J C
JC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D010996:Pleural Effusion / Q000209:etiology / Q000628:therapy*; D010997:Pleural Neoplasms / Q000150:complications / Q000556:secondary; D012008:Recurrence; D012189:Retrospective Studies; D013627:Talc / Q000008:administration & dosage* / Q000009:adverse effects; D013906:Thoracoscopy
D013627:Talc
Intérêt du talcage par thoracoscopie dans le traitement symptomatique des pleurésies récidivantes. A propos de 302 cas.