CHEST
Clinical InvestigationsThoracoscopy Talc Poudrage: A 15-Year Experience
Section snippets
Materials and Methods
This series consists of 614 consecutive patients (254 male,41.4%; 360 female, 58.6%; mean age, 54.5 years; range, 1 to 96 years)who underwent a diagnostic and/or therapeutic thoracoscopy with talcpoudrage pleurodesis from August 1983 to May 1999. According to thediagnosis, 157 patients (25.6%) had benign diseases (49 with pneumothorax and 108 with pleural effusions) and 457 patients (74.4%)had malignant pleural effusions. The patients with cancer wereclassified into two groups: breast cancer
Results
Sixty-four patients were excluded, including 30 patients (4.9%)because their lung did not expand at the time of the procedure, and 34patients (5.5%) because they died with in 30 days; 550 patients wereincluded in the final study. The differential diagnosis of the 105benign pleural effusions and the primary site of the 393 malignantpleural effusions included in the study are shown in Table 2.
Thoracoscopy with talc insufflation was very effective in preventingrecurrent pneumothorax (Table 1).
Discussion
Talc is believed to be one of the safest, cheapest, and mosteffective agents for promoting pleural symphysis. We were initiallyimpressed by the article of Frankel and coworkers,15 whoin 1961 published the results of an experimental study comparing theability of different chemical irritants to produce pleural symphysis. They concluded that talc produced the most homogenous and denseadhesions. Twenty years later, Weissberg16 summarized hisexperience with talc insufflation for pleurodesis in
ACKNOWLEDGMENT
We acknowledge and appreciate the assistance of Drs. Stephano J. G. Pereira and Andrea Oliveira Quim, in the review of the literature and information from patients' charts.
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