title: Talc pleurodesis through indwelling pleural catheters for malignant pleural effusions: retrospective case series of a novel clinical pathway.
abstract: Malignant pleural effusions cause significant morbidity, but there is no gold standard minimally invasive treatment. A new therapeutic approach combines talc pleurodesis and indwelling pleural catheters (IPCs) to enable outpatient management. This case series summarizes the safety and efficacy data of all patients (24) with a symptomatic malignant pleural effusion who underwent talc pleurodeses via IPCs between December 2010 and July 2013. Successful pleurodesis was achieved in 22 procedures (92%). There was one empyema, one hydropneumothorax, one recurrent effusion, and two minor complications: one drain site wound infection and one complaint of chest pain. Twenty-two procedures (92%) were performed in the outpatient setting. This report confirms the safety and efficacy of administering talc slurry through IPCs in an outpatient setting. Studies in a larger cohort are necessary to define the role of this novel approach in the treatment algorithm of patients with this condition.
authors.affiliation: Guy's and St Thomas' NHS Trust, London, England.
authors.forename: Liju
authors.initials: L
authors.lastname: Ahmed
authors.affiliation: Guy's and St Thomas' NHS Trust, London, England. Electronic address: Hughip@gmail.com.
authors.forename: Hugh
authors.initials: H
authors.lastname: Ip
authors.affiliation: Guy's and St Thomas' NHS Trust, London, England.
authors.forename: Deepak
authors.initials: D
authors.lastname: Rao
authors.affiliation: King's College London, London, England.
authors.forename: Nishil
authors.initials: N
authors.lastname: Patel
authors.affiliation: Guy's and St Thomas' NHS Trust, London, England.
authors.forename: Farinaz
authors.initials: F
authors.lastname: Noorzad
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods; D002408:Catheters, Indwelling; D015331:Cohort Studies; D019091:Critical Pathways; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D016066:Pleural Effusion, Malignant / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D018700:Pleurodesis / Q000379:methods*; D013902:Radiography, Thoracic / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D013627:Talc / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D013627:Talc