This is a retrospective analysis of 37 patients with transudative pleural effusions of different etiologies, which have been managed by thoracoscopic talc insufflation as a mode of relieving their dyspnea.
This review included 37 patients with transudative pleural effusions according to Light's criteria. There were 15 females and 22 male patients. Their mean age was 54.2 years. There were 28 patients with hepatic hydrothorax, 4 patients with lymphoma, 2 patients with cancer breast, 2 patients whose diagnoses remained unidentified, and 1 patient with multiple myeloma. Their average pleural fluid/serum protein ratio was 0.39, and their average pleural fluid/serum LDH 0.47. Thoracoscopic talc insufflation was performed using 2 gms of asbestos free talc.
Successful pleurodesis was achieved in 32 patients (86.4%) at the time of removal of the intercostal tube, while in 5 (13.5%), pleurodesis failed. Five of these 32 patients (15.6%) developed encysted pleural effusions that required no further interventions. Three months after the procedure, 29 patients were able to show for follow up. Of these, 22 patients had a sustained pleurodesis ((22 out of 29) (75.8%). Complications were minimal and mainly in the form of low grade fever in 14 patients (37.8%), chest pain in 9 patients (24.3%), and wound infection in 5 patients (13.5%).
Thoracoscopic talc insufflation is a safe procedure in patients with recurrent transudative pleural effusions of different etiologies. Patients may require pre-procedure correction of their serum albumin and correction of their bleeding profiles.
patients with symptomatic transudative pleural effusions of different etiologies could be safely managed with thoracoscopic talc insufflation.
Ahmed Al-Halfawy, No Financial Disclosure Information; No Product/Research Disclosure Information