title: Pleurodesis for malignant pleural effusions: a survey of physicians in South and Central America.
abstract: OBJECTIVE
  Pleurodesis is an effective alternative for the control of malignant pleural effusions. However, there is as yet no consensus regarding the indications for the procedure and the techniques employed therein. The objective of this study was to evaluate how pleurodesis is performed in South and Central America.
  
  
  METHODS
  Professionals who perform pleurodesis completed a questionnaire regarding the indications for the procedure, the techniques used therein, and the outcomes obtained.
  
  
  RESULTS
  Our sample comprised 147 respondents in Brazil, 49 in other South American countries, and 36 in Central America. More than 50% of the respondents reported performing pleurodesis only if pleural malignancy had been confirmed. However, scores on dyspnea and performance status scales were rarely used as indications for the procedure. Nearly 75% of the respondents in Brazil and in Central America preferred to perform pleurodesis only for recurrent effusions and stated that lung expansion should be 90-100%. Talc slurry, instilled via medium-sized chest tubes, was the agent most often employed. Thoracoscopy was performed in less than 25% of cases. Fever and chest pain were the most common side effects, and empyema occurred in < 14% of cases. The mean survival time after the procedure was most often reported to be 6-12 months.
  
  
  CONCLUSIONS
  There was considerable variation among the countries evaluated in terms of the indications for pleurodesis, techniques used, and outcomes. Talc slurry is the agent most commonly used, and thoracoscopy is the technique of choice in Brazil. Pleurodesis is an effective procedure that has few side effects, as evidenced by the low complication rates and high survival times.
authors.affiliation: Faculdade de Medicina de Jundiaí, Jundiaí, SP, Brasil. evmarchi@uol.com.br
authors.forename: Evaldo
authors.initials: E
authors.lastname: Marchi
authors.forename: Francisco Suso
authors.initials: FS
authors.lastname: Vargas
authors.forename: Bruna Affonso
authors.initials: BA
authors.lastname: Madaloso
authors.forename: Marcus Vinicius
authors.initials: MV
authors.lastname: Carvalho
authors.forename: Ricardo Mingarini
authors.initials: RM
authors.lastname: Terra
authors.forename: Lisete Ribeiro
authors.initials: LR
authors.lastname: Teixeira
mesh_terms: D000704:Analysis of Variance; D002489:Central America; D019538:Health Care Surveys; D006801:Humans; D016066:Pleural Effusion, Malignant / Q000628:therapy*; D018700:Pleurodesis / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013020:South America; D018709:Statistics, Nonparametric; D013627:Talc / Q000008:administration & dosage; D013906:Thoracoscopy / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D013627:Talc