Talc slurry pleurodesis in patients with secondary intractable pneumothorax: A phase 2 study

医学 胸膜成形术 滑石 气胸 外科 生理盐水 渗出 麻醉 胸膜腔 材料科学 复合材料
作者
Hideo Saka,Masahide Oki,Yoshikane Yamauchi,Chiyoe Kitagawa,Akiko Kada,Akiko Saito,Haruhiko Kondo,Hirotaka Kida,Noriaki Takahashi,Akihiro Bessho,Katsuhiro Okuda,Hideki Miyazawa
出处
期刊:Respiratory investigation [Elsevier]
卷期号:62 (2): 277-283
标识
DOI:10.1016/j.resinv.2024.01.005
摘要

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. 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. 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 %). Talc slurry pleurodesis is effective for intractable secondary pneumothorax, with minor side effects.
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