Who gains most? A 10-year experience with 611 thoracoscopic talc pleurodeses.
BACKGROUND
Thoracoscopic talc pleurodesis is a therapeutic option for recurrent pleural effusion.


METHODS
This retrospective study included 611 patients who underwent thoracoscopic talc pleurodesis between 1994 and 2003. We analyzed the risk factors, efficiency, outcome, follow-up, and survival, while taking into consideration primary disease and general condition.


RESULTS
The mean follow-up was 319 days (range, 31 to 1994). A total of 105 (17.2%) of 611 patients died within 30 days after treatment. Risk factors for death within 30 days included a Karnofsky index of less than 50%, a body mass index of less than 25 kg/m2, malignant disease, and male gender. Treatment was successful in 347 (68.6%) of 506 patients, and 451 (89.1%) reported an improvement in symptoms. Previous thoracic irradiation and a chest tube drainage time exceeding 10 days negatively influenced the outcome of pleurodesis. The survival rate was negatively influenced by a preoperative Karnofsky index of less than 60% and by malignant disease.


CONCLUSIONS
Patients with pleural effusion due to malignant disease gain from early pleurodesis. The most favorable outcome after talc pleurodesis was seen in women whose lungs were fully expandable, in patients whose Karnofsky index exceeded 60%, in patients whose body mass index was greater than 25 kg/m2, and in patients with benign disease.
Steger
Volker
V
Department of Thoracic Surgery, Schillerhoehe Hospital, Gerlingen, Germany. vrsteger@gmx.de
Mika
Ute
U
Toomes
Heikki
H
Walker
Tobias
T
Engel
Corinna
C
Kyriss
Thomas
T
Ziemer
Gerhard
G
Friedel
Godehard
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000628:therapy*; D016066:Pleural Effusion, Malignant / Q000628:therapy; D018700:Pleurodesis / Q000379:methods*; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D016019:Survival Analysis; D013627:Talc / Q000008:administration & dosage*; D013906:Thoracoscopy
D012597:Sclerosing Solutions; D013627:Talc