BACKGROUND:Chemical pleurodesis can be palliative for recurrent, symptomatic pleural effusions in patients who are not candidate for a thoracic surgical procedure. We hypothesized that effective pleurodesis could be accomplished with a rapid method of pleurodesis as effective as the standard method. METHODS: A prospective randomized 'non-inferiority' trial was conducted in 96 patients with malignant pleural effusion (MPE) who are not potentially curable and/or not amenable to any other surgical intervention. They were randomly allocated to group 1 (rapid pleurodesis) and to group 2 (standard protocol). In group 1, following complete fluid evacuation, talc slurry was instilled into the pleural space. This was accomplished within 2 h of thoracic catheter insertion, unless the drained fluid was more than 1,500 mL. After clamping the tube for 30 min, the pleural space was drained for 1 h, after which the thoracic catheter was removed. In group 2, talc-slurry was administered when the daily drainage was lower than 300 mL/day. RESULTS: No-complication developed due to talc-slurry in two groups. Complete or partial response was achieved in 35 (87.5%) and 33 (84.6%) patients in group 1 and group 2 respectively (P=0.670). The mean drainage time was 40.7 and 165.2 h in group 1 and group 2 respectively (P<0.001). CONCLUSIONS:Rapid pleurodesis with talc slurry is safe and effective and it can be performed in an outpatient basis.
RCT Entities:
BACKGROUND: Chemical pleurodesis can be palliative for recurrent, symptomatic pleural effusions in patients who are not candidate for a thoracic surgical procedure. We hypothesized that effective pleurodesis could be accomplished with a rapid method of pleurodesis as effective as the standard method. METHODS: A prospective randomized 'non-inferiority' trial was conducted in 96 patients with malignant pleural effusion (MPE) who are not potentially curable and/or not amenable to any other surgical intervention. They were randomly allocated to group 1 (rapid pleurodesis) and to group 2 (standard protocol). In group 1, following complete fluid evacuation, talc slurry was instilled into the pleural space. This was accomplished within 2 h of thoracic catheter insertion, unless the drained fluid was more than 1,500 mL. After clamping the tube for 30 min, the pleural space was drained for 1 h, after which the thoracic catheter was removed. In group 2, talc-slurry was administered when the daily drainage was lower than 300 mL/day. RESULTS: No-complication developed due to talc-slurry in two groups. Complete or partial response was achieved in 35 (87.5%) and 33 (84.6%) patients in group 1 and group 2 respectively (P=0.670). The mean drainage time was 40.7 and 165.2 h in group 1 and group 2 respectively (P<0.001). CONCLUSIONS:Rapid pleurodesis with talc slurry is safe and effective and it can be performed in an outpatient basis.
Authors: V B Antony; R Loddenkemper; P Astoul; C Boutin; P Goldstraw; J Hott; F Rodriguez Panadero; S A Sahn Journal: Eur Respir J Date: 2001-08 Impact factor: 16.671
Authors: Carolyn M Dresler; Jemi Olak; James E Herndon; William G Richards; Ernest Scalzetti; Stewart B Fleishman; Kemp H Kernstine; Todd Demmy; David M Jablons; Leslie Kohman; Thomas M Daniel; George B Haasler; David J Sugarbaker Journal: Chest Date: 2005-03 Impact factor: 9.410
Authors: Julius P Janssen; Gareth Collier; Phillippe Astoul; Gian Franco Tassi; Marc Noppen; Francisco Rodriguez-Panadero; Robert Loddenkemper; Felix Jf Herth; Stefano Gasparini; Charles H Marquette; Birgit Becke; Marios E Froudarakis; Peter Driesen; Chris T Bolliger; Jean-Marie Tschopp Journal: Lancet Date: 2007-05-05 Impact factor: 79.321