TY - JOUR
T1 - Talc slurry pleurodesis in patients with secondary intractable pneumothorax
T2 - A phase 2 study
AU - Saka, Hideo
AU - Oki, Masahide
AU - Yamauchi, Yoshikane
AU - Kitagawa, Chiyoe
AU - Kada, Akiko
AU - Saito, Akiko M.
AU - Kondo, Haruhiko
AU - Kida, Hirotaka
AU - Takahashi, Noriaki
AU - Bessho, Akihiro
AU - Okuda, Katsuhiro
AU - Miyazawa, Hideki
N1 - Publisher Copyright:
© 2024
PY - 2024/3
Y1 - 2024/3
N2 - Background: Secondary pneumothorax, which occurs most commonly in the elderly, is caused by underlying diseases. Cardiac dysfunction and other organ inefficiencies may render surgical repair impossible. Such non-operative and poor-risk cases are targets for pleurodesis, which involves the instillation of chemicals or irritants to the thoracic cavity through injection, bronchoscopic bronchial occlusion, or other procedures. Sterile graded talc has been used for pleurodesis mainly in Europe and the United States; however, only a few studies and case series investigating this topic have been published. This study evaluates the efficacy and safety of talc slurry pleurodesis. Methods: Patients with inoperable secondary intractable pneumothorax, who were not candidates for surgical repair, were recruited. Four grams of sterilized talc was suspended in 50 mL of physiological saline and injected through a tube into the pleural cavity. Additional 50 mL of saline was subsequently injected through the same channel to clean the residual saline in the injection tube. Another additional talc instillation was allowed to control persistent air leakage. The primary endpoint was the proportion of drainage tube removal within 30 days after talc pleurodesis. Results: Thirty-one patients were included in this study. In 23 out of 28 patients, the drainage tube could be removed within 30 days of talc instillation (82.1 %, 95 % CI = 63.1–93.9), exceeding the threshold of 36.0 % (p < 0.0001). The most common event was pain (11/28 patients, 39.3 %). Conclusions: Talc slurry pleurodesis is effective for intractable secondary pneumothorax, with minor side effects.
AB - Background: Secondary pneumothorax, which occurs most commonly in the elderly, is caused by underlying diseases. Cardiac dysfunction and other organ inefficiencies may render surgical repair impossible. Such non-operative and poor-risk cases are targets for pleurodesis, which involves the instillation of chemicals or irritants to the thoracic cavity through injection, bronchoscopic bronchial occlusion, or other procedures. Sterile graded talc has been used for pleurodesis mainly in Europe and the United States; however, only a few studies and case series investigating this topic have been published. This study evaluates the efficacy and safety of talc slurry pleurodesis. Methods: Patients with inoperable secondary intractable pneumothorax, who were not candidates for surgical repair, were recruited. Four grams of sterilized talc was suspended in 50 mL of physiological saline and injected through a tube into the pleural cavity. Additional 50 mL of saline was subsequently injected through the same channel to clean the residual saline in the injection tube. Another additional talc instillation was allowed to control persistent air leakage. The primary endpoint was the proportion of drainage tube removal within 30 days after talc pleurodesis. Results: Thirty-one patients were included in this study. In 23 out of 28 patients, the drainage tube could be removed within 30 days of talc instillation (82.1 %, 95 % CI = 63.1–93.9), exceeding the threshold of 36.0 % (p < 0.0001). The most common event was pain (11/28 patients, 39.3 %). Conclusions: Talc slurry pleurodesis is effective for intractable secondary pneumothorax, with minor side effects.
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U2 - 10.1016/j.resinv.2024.01.005
DO - 10.1016/j.resinv.2024.01.005
M3 - Article
C2 - 38266551
AN - SCOPUS:85183023803
SN - 2212-5345
VL - 62
SP - 277
EP - 283
JO - Respiratory Investigation
JF - Respiratory Investigation
IS - 2
ER -