title: Rapid pleurodesis is an outpatient alternative in patients with malignant pleural effusions: a prospective randomized controlled trial.
abstract: BACKGROUND
  Chemical pleurodesis can be palliative for recurrent, symptomatic pleural effusions in patients who are not candidate for a thoracic surgical procedure. We hypothesized that effective pleurodesis could be accomplished with a rapid method of pleurodesis as effective as the standard method.
  
  
  METHODS
  A prospective randomized 'non-inferiority' trial was conducted in 96 patients with malignant pleural effusion (MPE) who are not potentially curable and/or not amenable to any other surgical intervention. They were randomly allocated to group 1 (rapid pleurodesis) and to group 2 (standard protocol). In group 1, following complete fluid evacuation, talc slurry was instilled into the pleural space. This was accomplished within 2 h of thoracic catheter insertion, unless the drained fluid was more than 1,500 mL. After clamping the tube for 30 min, the pleural space was drained for 1 h, after which the thoracic catheter was removed. In group 2, talc-slurry was administered when the daily drainage was lower than 300 mL/day.
  
  
  RESULTS
  No-complication developed due to talc-slurry in two groups. Complete or partial response was achieved in 35 (87.5%) and 33 (84.6%) patients in group 1 and group 2 respectively (P=0.670). The mean drainage time was 40.7 and 165.2 h in group 1 and group 2 respectively (P<0.001).
  
  
  CONCLUSIONS
  Rapid pleurodesis with talc slurry is safe and effective and it can be performed in an outpatient basis.
authors.affiliation: Department of Thoracic Surgery, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Özkul
authors.affiliation: Department of Thoracic Surgery, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey.
authors.forename: Akif
authors.initials: A
authors.lastname: Turna
authors.affiliation: Department of Thoracic Surgery, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Demirkaya
authors.affiliation: Department of Thoracic Surgery, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Aksoy
authors.affiliation: Department of Thoracic Surgery, Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey.
authors.forename: Kamil
authors.initials: K
authors.lastname: Kaynak
keywords: Pleurodesis; malignant pleural effusion (MPE); slurry; talc