Talc Slurry Pleurodesis via Chest Tube in Department of Pulmonology—A 24-Case Study

Abstract

Chemical pleurodesis is an accepted palliative therapy for patients with recurrent and symptomatic pleural effusion. The aim of the study is to present our own experiences with a less invasive variant of this procedure performed with talc slurry administered via a chest tube under local anaesthesia. Available medical literature in Polish does not contain information about this type of pleurodesis. During 2005-2011 in the Pulmonology and Respiratory Rehabilitation Department we hospitalized and diagnosed 162 patients with pleural fluid. Pleurodesis was performed in 24 patients (14.8%) with persistent pleural fluid. In this article we present retrospective analysis of safety, efficacy of treatment and patients' survival time. We also provide detailed information about this type of pleurodesis: clinical theory, indications, contraindications, patient's preparation, description of procedure with our modifications and use of chest X-ray and transthoracic ultrasound. The procedure was effective in 20 cases, partially effective in 3 cases and ineffective in one case. In-hospital mortality was 4.2% (one case). We frequently observed mild fever and local pain. Median hospitalization was 9 days. Median survival time was 32 days, whereas in the group of still living patients it was 96 days. Talc slurry pleurodesis with adequate patient preselection is a relatively effective and safe procedure. The procedure can be performed in a non-surgical pulmonology unit.