Success Rate Of Talc Pleurodesis

Introduction: Pleurodesis is a common procedure performed by respiratory physicians and cardiothoracic surgeons in the treatment of malignant effusions or complicated pneumothorax. Talc is the most effective agent for chemical pleurodesis and is administered by instillation into the pleural cavity after the removal of pleural fluid. The authors aimed to determine the success rate of talc pleurodesis in patients treated at Mater Dei Hospital. Methods: The study included patients who had talc pleurodesis performed during an 18-month period between January 2016 and June 2017. Data was collected from electronic case summaries, PACS and iSoft using a standardised proforma. Results: From a total cohort of 81 patients, 97.5% of patients required talc pleurodesis for a malignant effusion. 60% of patients were female while 40% were male, and the median age was 71. 49.5% of the malignant effusions were a result of lung cancers, while other common malignancies metastasising to the pleura originated from the breasts and ovaries. Of the patients presenting with a pleural effusion, 13% had previous chest drain insertion while 5% had previous talc pleurodesis. Recurrence of the effusion stood at 56%, however only 14.8% of these required further drainage. 7% of patients undergoing pleurodesis survived less than 1 month. Conclusion: The success rate of talc pleurodesis was modest in our sample of patients, despite being performed by trained staff. The success rate could potentially be increased by better selection of patients and by introducing a standardised protocol for talc instillation.