Background: Chemical pleurodesis is an effective
treatment for malignant pleural effusion and pneumothorax. This mode of
therapy is, however, less widely accepted in the treatment of patients
with refractory benign or undiagnosed pleural effusion.
Study objectives: To analyze the outcome of talc slurry
pleurodesis in patients with nonmalignant pleural effusions.
Design: Retrospective and partly prospective analysis of
Setting: Hadassah University
Hospital, Jerusalem, Israel.
participants: Between 1992 and 1997, we treated 16 patients with
nonmalignant pleural effusion using talc slurry pleurodesis. The cause
of effusion was congestive heart failure in 6 patients, liver cirrhosis
in 4 patients, yellow nail syndrome in 1 patient, systemic lupus
erythematosus in 1 patient, chylothorax in 1 patient, and undiagnosed
in 3 patients.
Interventions: Nine patients were
hospitalized, and seven patients received treatment in a day-care
setting. Follow-up ranged from 2 months to 3 years.
Results: Complete success was observed in 12 cases (75%),
partial success in 3 cases (19%), and pleurodesis was ineffectual in 1
case (6%). There were no significant complications after the procedure
in any of our patients. A review of the English-language medical
literature revealed an additional 110 reported cases of nonmalignant
pleural effusion that were treated with chemical pleurodesis. Of these
cases, talc was used in 65% with a success rate of nearly 100%.
Conclusions: Chemical pleurodesis, and specifically talc
slurry, is an effective treatment for recurrent benign or undiagnosed
pleural effusion. This procedure is safe and easily performed and, in
selected cases, can be performed in an outpatient day-care