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ICVTS on-line discussion A

Sacred Heart Hospital, 451 Chew St., Allentown, PA 18102, USA

Is talc pleurodesis safe for young patients following primary spontaneous pneumothorax?

While there is little doubt that VATs talc pleurodysis is effective in treating primary spontaneous pneumothorax [1], so are other methods (e.g. limited thoracotomy with mechanical pleural abrasion, and/or pleurectomy, and/or bullectomy.) VATs without talc or these adjuncts appears to be less reliable in preventing recurrent pneumothorax. The question asked is "safety" of the talc in this setting. Even a low incidence of adverse longterm effects of talc would be unacceptable. Talc pleurodysis for malignant effusions is a completely different issue since the patients generally have a short life expectancy. I have had one unfortunate experience in which talc pleurodysis was used for an effusion which was mistakenly thought to be malignant. The patient returned a few months later with an empyema necessitans and markedly thickened (>1 cm), fibrotic pleura. Decortication was exceedingly difficult. Did the intrapleural talc contribute to or cause the problem? I urge caution in the use of talc in young patients and suggest alternate methods of achieving pleurodysis are preferable.

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1. Hunt I, Barber B, Southon R, Treasure T. Is talc pleurodesis safe for young patients following primary spontaneous pneumothorax? Interact CardioVasc Thorac Surg doi:10.1510/icvts.2006.147546 [update!].[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Michael C. Sinclair Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Sinclair, M. C. Search for Related Content PubMed PubMed Citation Articles by Sinclair, M. C. Related Collections Related Article