To document the success or failure of talc pleurodesis depending on CXR findings and the amount of pleural fluid drainage in twenty four hours prior to pleurodesis.
A retrospective analysis was performed over a period of five years on patients treated with talc pleurodesis through chest tubes or by surgery (VATS or thoracotomy). The amount of pleural fluid drained within 24-hours and chest x-ray findings were evaluated prior to pleurodesis. Success was documented if no recurrences of these effusions were noted for at least period of three months and no further intervention was necessary.
94 patients fit our criteria. 16 patients were discarded as no CXR was performed after pleurodesis. With CXRs showing minimal residual pleural effusions, talc pleurodesis was successful in 100% of patients if the pleural fluid drainage was less than 100mls in 24 hours (30/30 patients); 60% successful if pleural fluid drainage was between 100mls and 200mls in 24 hours (9/15 patients); 38% successful if the pleural fluid drainage was between 200mls and 300mls in 24 hours (5/13 patients); and 20% successful if pleural fluid drainage was over 300mls in 24 hours (4/20 patients). Only one out of eleven patients with pleural fluid drainage over 300mls in twenty hours had talc pleurodesis via VATS that was successful (9%).
Talc pleurodesis is very successful when the pleural fluid drainage is less than 100mls in 24 hours regardless of the method of administration. Patients with pleural fluid drainage less than 250mls in 24 hours may also be successful if the chest x-ray shows minimal residual effusions. Talc pleurodesis should not be performed if the pleural fluid drainage is over 300mls or if CXR shows moderate and loculated pleural effusions.
The success of talc pleurodesis depends on the amount of pleural fluid drained in 24 hours as well as the amount of pleural fluid noted on chest x-rays prior to therapy, regardless if performed via chest tubes or by VATS.
George Thommi, None.