Talc pleurodesis through indwelling pleural catheters for malignant pleural effusions: retrospective case series of a novel clinical pathway

Chest. 2014 Dec;146(6):e190-e194. doi: 10.1378/chest.14-0394.

Abstract

Malignant pleural effusions cause significant morbidity, but there is no gold standard minimally invasive treatment. A new therapeutic approach combines talc pleurodesis and indwelling pleural catheters (IPCs) to enable outpatient management. This case series summarizes the safety and efficacy data of all patients (24) with a symptomatic malignant pleural effusion who underwent talc pleurodeses via IPCs between December 2010 and July 2013. Successful pleurodesis was achieved in 22 procedures (92%). There was one empyema, one hydropneumothorax, one recurrent effusion, and two minor complications: one drain site wound infection and one complaint of chest pain. Twenty-two procedures (92%) were performed in the outpatient setting. This report confirms the safety and efficacy of administering talc slurry through IPCs in an outpatient setting. Studies in a larger cohort are necessary to define the role of this novel approach in the treatment algorithm of patients with this condition.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care / methods
  • Catheters, Indwelling*
  • Cohort Studies
  • Critical Pathways
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Safety
  • Pleural Effusion, Malignant / diagnosis
  • Pleural Effusion, Malignant / mortality
  • Pleural Effusion, Malignant / therapy*
  • Pleurodesis / methods*
  • Radiography, Thoracic / methods
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Survival Rate
  • Talc / therapeutic use*
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Talc

Associated data

  • ISRCTN/ISRCTN73255764