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Ann Thorac Surg 2007;83:1940-1945
© 2007 The Society of Thoracic Surgeons

Original Articles: General Thoracic

Who Gains Most? A 10-Year Experience With 611 Thoracoscopic Talc Pleurodeses

Volker Steger, MDa,*, Ute Mikaa, Heikki Toomes, MDa, Tobias Walker, MDb, Corinna Engelc, Thomas Kyriss, MDa, Gerhard Ziemer, MDb, Godehard Friedel, MDa

a Department of Thoracic Surgery, Schillerhoehe Hospital, Gerlingen, Germany
b Department of Thoracic, Cardiac and Vascular Surgery, Tuebingen, Germany
c Institute for Medical Information Processing, University of Tuebingen, Tuebingen, Germany

Accepted for publication February 21, 2007.

* Address correspondence to Dr Steger, Department of Thoracic Surgery, Schillerhöhe Hospital, Solitudestr 18, 70839 Gerlingen, Germany (Email: vrsteger{at}gmx.de).

Background: Thoracoscopic talc pleurodesis is a therapeutic option for recurrent pleural effusion.

Methods: This retrospective study included 611 patients who underwent thoracoscopic talc pleurodesis between 1994 and 2003. We analyzed the risk factors, efficiency, outcome, follow-up, and survival, while taking into consideration primary disease and general condition.

Results: The mean follow-up was 319 days (range, 31 to 1994). A total of 105 (17.2%) of 611 patients died within 30 days after treatment. Risk factors for death within 30 days included a Karnofsky index of less than 50%, a body mass index of less than 25 kg/m2, malignant disease, and male gender. Treatment was successful in 347 (68.6%) of 506 patients, and 451 (89.1%) reported an improvement in symptoms. Previous thoracic irradiation and a chest tube drainage time exceeding 10 days negatively influenced the outcome of pleurodesis. The survival rate was negatively influenced by a preoperative Karnofsky index of less than 60% and by malignant disease.

Conclusions: Patients with pleural effusion due to malignant disease gain from early pleurodesis. The most favorable outcome after talc pleurodesis was seen in women whose lungs were fully expandable, in patients whose Karnofsky index exceeded 60%, in patients whose body mass index was greater than 25 kg/m2, and in patients with benign disease.






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