Recent studies have reported fever as a side effect of talc poudrage during thoracoscopic pleurodesis. However, thoracoscopy itself is likely to induce systemic inflammatory reaction, as it is an interventional procedure. The aim of the study was to investigate whether systemic inflammatory response is due to talc poudrage or to thoracoscopy.
We prospectively studied two groups of patients: the first group, of 18 patients, underwent thoracoscopic talc poudrage and the second, of 17 patients, underwent only diagnostic thoracoscopy. We measured body temperature, as well as white blood cells (WBC) count and CRP before (baseline), at 24h and 48h after the procedure. No anti-inflammatory medication was permitted before, during or after the procedure. All patients have a 3-month follow-up.
Baseline patients’ characteristics were similar in both groups. Temperature increased significantly in the thoracoscopic talc poudrage group (overall p=0.005) especially at 9, 12 and 24 hour after the procedure. Overall WBC count (p=0.004), neutrophils (p=0.03) and CRP (p<0.0001) were significantly increased in the group of patients who underwent thoracoscopic talc poudrage. In the contrary, lymphocytes were significantly decreased (overall p=0.01) in the thoracoscopic talcage group during the same period. Mild side effects were noted such as pain during and after thoracoscopy and subcutaneous emphysema. No severe complication, such as infection or acute respiratory failure, was noted in both groups during the hospitalization or during the follow-up period.
According to our results, fever and systemic inflammatory reaction is due to talc poudrage and not to thoracoscopy.
Fever, especially in patients with talc poudrage, is only due to a short term inflammatory reaction. This observation should decrease significantly the overall cost of thoracoscopy.
Marios Froudarakis, None.