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[Malignant pleural effusions: recourse to early use of talc]
1Service de pneumologie, institut Paoli-Calmettes, Marseille, France.
Introduction:
Our purpose was to assess the efficacy, permanence and safety of thoracoscopic talc poudrage (TTP) for pleurodesis in malignant effusions. We report the follow-up of 360 patients who received TTP in two centers in Marseille (France).
Current Knowledge And Key Points:
Eighty-eight patients presented with mesothelioma and 272 had pleural metastasis. The mean follow-up time was 12 months (range: 2-120). Out of the 327 patients whose response could be evaluated, 90.2% had a successful pleurodesis at 1 month, and 82.1% had a life-long pleural symphysis. Adverse effects included one death 3 days after the procedure in an end-stage patient, fever (9.8%), infection of the parietal scar (2.5%) and pulmonary infection (0.8%).
Future Prospects And Projects:
TTP is an effective and safe method of life-long pleurodesis. It should be performed early on in the history of malignant effusions to avoid failures of the technic, mainly linked to trapped lung and to the general condition of patients.
Insights
Thoracoscopic talc poudrage (TTP) is a safe and effective pleurodesis for malignant effusions, achieving lifelong symphysis in over 80% of patients. Early intervention is recommended for optimal outcomes.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Oncology
Context:
- Malignant pleural effusions are a common complication of cancer.
- Pleurodesis aims to prevent fluid re-accumulation.
- Thoracoscopic talc poudrage (TTP) is a minimally invasive technique for pleurodesis.
Purpose:
- To evaluate the efficacy, permanence, and safety of TTP for pleurodesis in malignant effusions.
- To report the long-term follow-up of patients undergoing TTP.
Summary:
- A study of 360 patients with malignant effusions (mesothelioma or pleural metastasis) who underwent TTP.
- Successful pleurodesis was achieved in 90.2% at 1 month, with 82.1% experiencing lifelong pleural symphysis.
- Adverse events were infrequent, including fever, infection, and one procedure-related death in an end-stage patient.
Impact:
- TTP is confirmed as an effective and safe method for achieving lifelong pleurodesis.
- Early TTP is crucial to mitigate failures associated with trapped lung and patient's general condition.
- This procedure offers a valuable option for managing malignant effusions, improving patient outcomes.