HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hartman, D. L. Articles by Mathur, P. N. Search for Related Content PubMed PubMed Citation Articles by Hartman, D. L. Articles by Mathur, P. N.

The Journal of Thoracic and Cardiovascular Surgery, Vol 105, 743-747, Copyright © 1993 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Comparison of insufflated talc under thoracoscopic guidance with standard tetracycline and bleomycin pleurodesis for control of malignant pleural effusions

DL Hartman, JM Gaither, KA Kesler, DM Mylet, JW Brown and PN Mathur
Department of Medicine, Indiana University School of Medicine, Indianapolis.

The standard palliation of malignant pleural effusions involves tube thoracostomy drainage with chemical pleurodesis. The insufflation of intrapleural talc under thoracoscopic guidance (n = 39) was evaluated against documented controls that consisted of patients (n = 85) who participated in a randomized study with tube thoracostomy drainage followed by either bleomycin or tetracycline sclerosis. Under local anesthesia, which was supplemented by intravenous sedation, patients in the talc group underwent complete pleural fluid evacuation. The talc was then insufflated evenly on the entire pleural surface under thoracoscopic guidance. Of the patients in the talc group who survived their disease process, 97% had a successful pleurodesis at 30 days and 95% at 90 days. In comparison, the bleomycin group demonstrated a success rate of 64% at 30 days and 70% at 90 days (p = 0.003 and p = 0.047 versus the talc group). The tetracycline group had successful pleurodesis in only 33% at 30 days and 47% at 90 days (p < 0.001 and p < 0.001 versus the talc group). There were only two patients in the talc group in whom pleurodesis was not successful, and both were subsequently found to have extraluminal compression of the right lower lobe bronchus, which prevented lung reexpansion. These data demonstrate that the insufflation of talc into the pleural cavity under thoracoscopic guidance is a safe and efficacious procedure in the control of malignant pleural effusions.

This article has been cited by other articles:

				A. R. Haas, D. H. Sterman, and A. I. Musani Malignant Pleural Effusions: Management Options With Consideration of Coding, Billing, and a Decision Approach Chest, September 1, 2007; 132(3): 1036 - 1041. [Abstract] [Full Text] [PDF]

				V. Steger, U. Mika, H. Toomes, T. Walker, C. Engel, T. Kyriss, G. Ziemer, and G. Friedel Who Gains Most? A 10-Year Experience With 611 Thoracoscopic Talc Pleurodeses Ann. Thorac. Surg., June 1, 2007; 83(6): 1940 - 1945. [Abstract] [Full Text] [PDF]

				S. Bilaceroglu, Y. Guo, M. L. Hawthorne, Z. Zhu, G. T. Stathopoulos, K. B. Lane, and R. W. Light Oral Forms of Tetracycline and Doxycycline Are Effective in Producing Pleurodesis Chest, November 1, 2005; 128(5): 3750 - 3756. [Abstract] [Full Text] [PDF]

				M. A. Zgoda, W. Lunn, S. Ashiku, A. Ernst, and D. Feller-Kopman Direct Visual Guidance for Chest Tube Placement Through a Single-Port Thoracoscopy: A Novel Technique Chest, May 1, 2005; 127(5): 1805 - 1807. [Full Text] [PDF]

				C. M. Dresler, J. Olak, J. E. Herndon II, W. G. Richards, E. Scalzetti, S. B. Fleishman, K. H. Kernstine, T. Demmy, D. M. Jablons, L. Kohman, et al. Phase III Intergroup Study of Talc Poudrage vs Talc Slurry Sclerosis for Malignant Pleural Effusion Chest, March 1, 2005; 127(3): 909 - 915. [Abstract] [Full Text] [PDF]

				V. B. Antony, N. Nasreen, K. A. Mohammed, P. S. Sriram, W. Frank, N. Schoenfeld, and R. Loddenkemper Talc Pleurodesis: Basic Fibroblast Growth Factor Mediates Pleural Fibrosis Chest, November 1, 2004; 126(5): 1522 - 1528. [Abstract] [Full Text] [PDF]

				C Parker and E Neville Lung cancer * 8: Management of malignant mesothelioma Thorax, September 1, 2003; 58(9): 809 - 813. [Full Text] [PDF]

				G Antunes, E Neville, J Duffy, and N Ali BTS guidelines for the management of malignant pleural effusions Thorax, May 1, 2003; 58(90002): ii29 - 38. [Full Text]

				E. M. Marom, J. J. Erasmus, J. E. Herndon II, C. Zhang, and H. P. McAdams Usefulness of Imaging-Guided Catheter Drainage and Talc Sclerotherapy in Patients with Metastatic Gynecologic Malignancies and Symptomatic Pleural Effusions Am. J. Roentgenol., July 1, 2002; 179(1): 105 - 108. [Abstract] [Full Text] [PDF]

				V.B. Antony, R. Loddenkemper, P. Astoul, C. Boutin, P. Goldstraw, J. Hott, F. Rodriguez Panadero, and S.A. Sahn Management of malignant pleural effusions Eur. Respir. J., August 1, 2001; 18(2): 402 - 419. [Full Text] [PDF]

				S. A. Sahn Talc Should Be Used for Pleurodesis Am. J. Respir. Crit. Care Med., December 1, 2000; 162(6): 2023 - 2024. [Full Text]

				Management of Malignant Pleural Effusions Am. J. Respir. Crit. Care Med., November 1, 2000; 162(5): 1987 - 2001. [Full Text]

				A. H. DIACON, C. WYSER, C. T. BOLLIGER, M. TAMM, M. PLESS, A. P. PERRUCHOUD, and M. SOLER Prospective Randomized Comparison of Thoracoscopic Talc Poudrage under Local Anesthesia versus Bleomycin Instillation for Pleurodesis in Malignant Pleural Effusions Am. J. Respir. Crit. Care Med., October 1, 2000; 162(4): 1445 - 1449. [Abstract] [Full Text] [PDF]

				D. H. Sterman, L. R. Kaiser, and S. M. Albelda Advances in the Treatment of Malignant Pleural Mesothelioma Chest, August 1, 1999; 116(2): 504 - 520. [Abstract] [Full Text] [PDF]

				V. M. Macaulay, K. J. O'Byrne, M. P. Saunders, J. P. Braybrooke, L. Long, F. Gleeson, C. S. Mason, A. L. Harris, P. Brown, and D. C. Talbot Phase I Study of Intrapleural Batimastat (BB-94), a Matrix Metalloproteinase Inhibitor, in the Treatment of Malignant Pleural Effusions Clin. Cancer Res., March 1, 1999; 5(3): 513 - 520. [Abstract] [Full Text] [PDF]

				E. M. Marom, E. F. Patz Jr, J. J. Erasmus, H. P. McAdams, P. C. Goodman, and J. E. Herndon Malignant Pleural Effusions: Treatment with Small-Bore-Catheter Thoracostomy and Talc Pleurodesis Radiology, January 1, 1999; 210(1): 277 - 281. [Abstract] [Full Text]

				A. P. C. Yim, A. T. C. Chan, T. W. Lee, I. Y. P. Wan, and J. K. S. Ho Thoracoscopic Talc Insufflation Versus Talc Slurry for Symptomatic Malignant Pleural Effusion Ann. Thorac. Surg., December 1, 1996; 62(6): 1655 - 1658. [Abstract] [Full Text]

				M. J. Mack, R. J. Landreneau, A. P. Yim, S. R. Hazelrigg, and G. R. Scruggs RESULTS OF VIDEO-ASSISTED THYMECTOMY IN PATIENTS WITH MYASTHENIA GRAVIS J. Thorac. Cardiovasc. Surg., November 1, 1996; 112(5): 1352 - 1360. [Abstract] [Full Text]

				R. G. Cohen, W. W. Shely, S. E. Thompson, J. A. Hagen, C. C. Marboe, T. R. DeMeester, and V. A. Starnes Talc Pleurodesis: Talc Slurry Versus Thoracoscopic Talc Insufflation in a Porcine Model Ann. Thorac. Surg., October 1, 1996; 62(4): 1000 - 1002. [Abstract] [Full Text]