title: Who gains most? A 10-year experience with 611 thoracoscopic talc pleurodeses.
abstract: 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.
authors.affiliation: Department of Thoracic Surgery, Schillerhoehe Hospital, Gerlingen, Germany. vrsteger@gmx.de
authors.forename: Volker
authors.initials: V
authors.lastname: Steger
authors.forename: Ute
authors.initials: U
authors.lastname: Mika
authors.forename: Heikki
authors.initials: H
authors.lastname: Toomes
authors.forename: Tobias
authors.initials: T
authors.lastname: Walker
authors.forename: Corinna
authors.initials: C
authors.lastname: Engel
authors.forename: Thomas
authors.initials: T
authors.lastname: Kyriss
authors.forename: Gerhard
authors.initials: G
authors.lastname: Ziemer
authors.forename: Godehard
authors.initials: G
authors.lastname: Friedel
mesh_terms: 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
chemical_list: D012597:Sclerosing Solutions; D013627:Talc