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Talc pleurodesis

Rebecca Krochmal, Chakravarthy Reddy, Lonny Yarmus, Neeraj R Desai, David Feller-Kopman, Hans J Lee
BACKGROUND: Malignant pleural effusions (MPEs) represent advanced stage disease with potentially significant patient discomfort due to dyspnea. Palliative management options include repetitive thoracenteses, placement of a tunneled pleural catheter (TPC), chemical pleurodesis, or some combination of these procedures. The rapid pleurodesis procedure combines thoracoscopic talc pleurodesis and insertion of a TPC at the same time with the goals of reducing both the length of hospitalization and the duration of catheter use...
September 2016: Journal of Thoracic Disease
Oliver J Bintcliffe, Gary Y C Lee, Najib M Rahman, Nick A Maskell
The evidence base concerning the management of benign pleural effusions has lagged behind that of malignant pleural effusions in which recent randomised trials are now informing current clinical practice and international guidelines.The causes of benign pleural effusions are broad, heterogenous and patients may benefit from individualised management targeted at both treating the underlying disease process and direct management of the fluid. Pleural effusions are very common in a number of non-malignant pathologies, such as decompensated heart failure, and following coronary artery bypass grafting...
September 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
Kango Nohara, Kazuto Takada, Eiji Kojima, Kiyoko Ninomiya, Shoko Miyamatsu, Takahiro Shimizu, Tsutomu Sakurai, Takaaki Mizuno, Yuuki Yamashita
BACKGROUND: The choice of an optimal sclerosant for pleurodesis for malignant pleural effusion remains controversial. This retrospective clinical study compared the efficacy and safety of two sclerosants; talc slurry (talc-s) and OK-432. METHODS: We compared the characteristics, 30/90-day success rates, and adverse events in patients with lung adenocarcinoma who underwent pleurodesis by using either OK-432 or talc-s. Propensity score matching was used to compare the two scelrosants...
September 2016: Respiratory Investigation
Susan Walker, Marijana Zubrinic, Christine Massey, Yaron Shargall, Eric Bédard, Gail Darling
BACKGROUND: In a patient population with a limited life expectancy, malignant pleural effusion can significantly impact quality of life (QoL). Different treatment options are available, each with its own effect on QoL. To date, satisfaction with treatment options has not been evaluated. PURPOSE: To evaluate QoL and satisfaction with treatment using patient-reported outcomes for four different treatment strategies. DESIGN: A prospective, cohort study that compared four treatment options: indwelling pleural catheter (IPC); video assisted thoracic surgery (VATS) and IPC; chest tube and talc slurry; and VATS talc poudrage...
July 2, 2016: International Journal of Palliative Nursing
Dong Woog Yoon, Jong Ho Cho, Yong Soo Choi, Jhingook Kim, Hong Kwan Kim, Jae Ill Zo, Young Mog Shim
BACKGROUND: Patients with malignant pleural effusion have a limited life expectancy. An increase in pleural and oncological treatment options and more accurate prognostic evaluation may help individualize treatment strategies. The aim of this study was to identify the prognostic indicators of overall survival (OS) after video-assisted thoracic surgery (VATS) talc pleurodesis for malignant pleural effusion. METHODS: We examined the medical records of all consecutive patients with malignant pleural effusion who underwent VATS talc pleurodesis from 2006 to 2008 at the Samsung Medical Center...
July 2016: Thoracic Cancer
Andrea Droghetti, Jacopo Vannucci, Antonello Bufalari, Guido Bellezza, Valentina De Monte, Giuseppe Marulli, Maria Caterina Bottoli, Michele Giovanardi, Niccolò Daddi, Verena De Angelis, Franco Moriconi, Francesco Puma
Sclerosing fluids to achieve pleurodesis could be hardly replaced for bed-side procedures, but other devices may be successfully applied during thoracoscopy. Thulium Cyber Laser was experimented for this purpose and compared to talc poudrage. Twenty pigs underwent operative videothoracoscopy (VATS). Ten models were subjected to double-port VATS and parietal pleura photoevaporation using Thulium Cyber Laser™ (TCL) 150 W 2010 nm on the posterior third of three ribs; the pleural surface was homogeneously treated inside the target perimeter...
September 2016: Lasers in Medical Science
Jian-Bo Lin, Fan-Cai Lai, Xu Li, Yuan-Rong Tu, Min Lin, Min-Lian Qiu, Rong-Gang Luo, Bo Liu, Jing-Wei Lin
With the advent of molecularly targeted therapy, it is necessary to reconsider the strategy for malignant pleural effusion in non-small-cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations. The aim of this study was to evaluate the efficacy of a two-line sequential treatment strategy in this patient subgroup. First-line treatment was gefitinib (250 mg/day) until disease progression. Second-line treatment was thoracoscopic talc pleurodesis followed by chemotherapy. Primary endpoints were the overall response and progression-free survival rates after first-line treatment, and the overall survival rate after first- and second-line treatment...
June 29, 2016: Journal of Drug Targeting
Katherina-Bernadette Sreter, Marko Jakopovic, Zoran Janevski, Miroslav Samarzija, Paul Zarogoulidis, Ioannis Kioumis, Nikolaos Mparmpetakis, Athanasia Pataka, Konstantinos Zarogoulidis, Theodora Tsiouda, Christoforos Kosmidis, Sofia Mpaka, Haidong Huang, Wolfgang Hohenforst-Schmidt, Charalampos Charalampidis, Nikolaos Machairiotis, Bojan Zaric, Aleksandar Milovancev
BACKGROUND: Lung cancer is the leading cause of malignant pleural effusion (MPE). Management of MPEs remains a clinical challenge due to recurrence and poor quality of life. An ideal sclerosing agent has yet to be found. The aim of this cohort pilot study was to evaluate the role of mitoxantrone pleurodesis (MP) as an alternative to talc sclerotherapy for managing MPEs in lung cancer patients. METHODS: A retrospective chart review was conducted on consecutively admitted patients with MPE to the Department of Post-Intensive Care at the Clinic for Respiratory Diseases "Jordanovac", University Hospital Centre Zagreb, in Croatia...
May 2016: Annals of Translational Medicine
Hany Hasan Elsayed, Aly Hassaballa, Taha Ahmed
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was [in patients with secondary spontaneous pneumothorax (SSP)] is [video-assisted thoracoscopic surgery talc pleurodesis] superior to [talc pleurodesis through tube thoracostomy] in terms of [absence of recurrence and procedure morbidity]? Seventy-three papers were found using the reported search. In looking through our search strategy, we selected studies comparing both procedures and studies performing either procedures and stating their outcome, morbidity mortality and rate of recurrence...
September 2016: Interactive Cardiovascular and Thoracic Surgery
Akash Verma, Akhil Chopra, Yeo W Lee, Lavina D Bharwani, Atasha B Asmat, Dokeu B A Aneez, Fazuludeen A Akbar, Albert Y H Lim, Sanjay H Chotirmall, John Abisheganaden
BACKGROUND AND OBJECTIVE: Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors (EGFR-TKIs) are effective against lung adenocarcinoma. However, limited data is available assessing the effectiveness of EGFR-TKI use in preventing re-accumulation of MPE. To our knowledge, there is no literature on comparison of talc pleurodesis with EGFR-TKIs alone on re-accumulation of MPE in Asian population. We investigated if EGFR-TKI therapy for advanced lung adenocarcinoma with malignant pleural effusion (MPE) is also successful in preventing pleural fluid re-accumulation following initial drainage...
2016: Current Drug Discovery Technologies
Serdar Evman, Levent Alpay, Serda Metin, Hakan Kıral, Mine Demir, Murat Yalçinsoy, Volkan Baysungur, Irfan Yalçinkaya
INTRODUCTION: Prolonged air leak in secondary spontaneous pneumothorax (SSP) patients remains one of the biggest challenges for thoracic surgeons. This study investigates the feasibility, effectiveness, clinical outcomes, and economical benefits of the autologous blood patch pleurodesis method in SSP. MATERIAL AND METHODS: First-episode SSP patients undergoing autologous blood patch pleurodesis for resistant air leak following underwater-seal thoracostomy, between January 2010 and June 2013 were taken into the study...
March 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Yasunori Iwasaki, Shinzo Takamori, Masahiro Mitsuoka, Masaki Kashihara, Tatsuya Nishi, Daigo Murakami, Ryoichi Matsumoto, Hiroharu Mifune, Yuji Tajiri, Yoshito Akagi
OBJECTIVE: This study was performed to evaluate the change of pleural cavity by talc pleurodesis for carcinomatous pleuritis in an animal model. METHODS: Models of malignant pleuritis were produced by an intra-venous injection of lung adenocarcinoma cells to male BALB/c nude mice at 6 weeks of age. Two weeks after the injection, either talc or saline was injected into the left thoracic cavity and the mice were further observed for 4 weeks. Six weeks after the injection, they were killed and the occurrence of lung cancer, amount of pleural effusion, and histological change of the pleural cavity were examined and compared between the two groups with or without talc administration...
July 2016: General Thoracic and Cardiovascular Surgery
Amelia O Clive, Hayley E Jones, Rahul Bhatnagar, Nancy J Preston, Nick Maskell
BACKGROUND: Malignant pleural effusion (MPE) is a common problem for people with cancer as a result of malignant infiltration of the pleura. It is usually associated with considerable breathlessness. A number of treatment options are available to manage the uncontrolled accumulation of pleural fluid including administration of a pleurodesis agent (either via a chest tube or at thoracoscopy) or indwelling pleural catheter insertion. OBJECTIVES: To ascertain the optimal management strategy for adults with malignant pleural effusion in terms of pleurodesis success...
2016: Cochrane Database of Systematic Reviews
Jacopo Vannucci, Andrea Droghetti, Antonello Bufalari, Valentina De Monte, Guido Bellezza, Fortunato Bianconi, Roberta Pecoriello, Niccolò Daddi, Franco Moriconi, Francesco Puma
OBJECTIVES: The human fibrinogen/thrombin surgical patch is proposed for videothoracoscopic pleurodesis after recurrent observation in routine clinical practice of site-specific pleuro-pulmonary adhesions. METHODS: A total of 36 experimental videothoracoscopies were performed on 18 pigs, all of which underwent a bilateral sequential procedure. The right or left side was casually approached and two 4.8 × 4.8 cm Tachosil® patches were placed over the dorsal lung surface in the highest antigravitary position through a double-port thoracoscopy...
April 22, 2016: European Journal of Cardio-thoracic Surgery
Junko Murakami, Kensuke Hori, Rieko Okubo, Kanoko Miyagi, Mayu Shiomi, Kiri Uragami, Mio Nakagawa, Emi Yoshioka, Tomohiko Tsuruta, Rina Tashima, Kimihiko Ito
We encountered a case of uterine leiomyosarcoma with multiple lung metastases. The patient was a 52-year-old woman who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by chemotherapy with gemcitabine and docetaxel. After 1 cycle of chemotherapy, the lung metastasis was reduced, but at the same time, she developed bilateral pneumothorax. Chemical pleurodesis using talc was performed. The lungs were expanded and stabilized in 7 days. After 5 cycles of chemotherapy were administered, no recurrence of pneumothorax and adverse effects were observed...
February 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Pietro Bertoglio, David A Waller
Surgery has a key role at different points in the management of Malignant Pleural Mesothelioma. Diagnosis with video assisted thoracoscopy offers excellent sensitivity and specificity and a direct view of the pleural cavity to verify the extent of the tumor. Nodal involvement can be assessed by mediastinoscopy and either talc pleurodesis or partial pleurectomy can be used for symptom control in advanced stage disease. Extra Pleural Pneumonectomy (EPP) and Extended Pleurectomy Decortication (EPD) are used to prolong survival although the benefit of radical surgery has not has been fully clarified; EPP failed to show its benefit in the MARS trial and EPD is currently under investigation in the MARS2 trial...
June 2016: Expert Review of Respiratory Medicine
Macy M S Lui, Rajesh Thomas, Y C Gary Lee
The growing utilisation of indwelling pleural catheters (IPCs) has put forward a new era in the management of recurrent symptomatic pleural effusions. IPC use is safe compared to talc pleurodesis, though complications can occur. Pleural infection affects <5% of patients, and is usually responsive to antibiotic treatment without requiring catheter removal or surgery. Pleural loculations develop over time, limiting drainage in 10% of patients, which can be improved with intrapleural fibrinolytic therapy. Catheter tract metastasis can occur with most tumours but is more common in mesothelioma...
2016: BMJ Open Respiratory Research
Alireza Hamidian Jahromi, Sergei Kalsow, Navdeep Samra, Vyas Ramuhalli Rao
No abstract text is available yet for this article.
March 2015: American Surgeon
Robert C Rintoul
Malignant pleural mesothelioma, a uniformly fatal cancer caused by prior asbestos exposure, places a major burden on society. The MesoVATS trial was a multicenter randomized controlled trial that examined the role of video-assisted thoracoscopic partial pleurectomy (VAT-PP) versus talc pleurodesis in patients with malignant pleural mesothelioma. Overall there was no difference in survival between VAT-PP and talc pleurodesis. VAT-PP resulted in more complications, longer hospital stay and was more expensive...
2015: Future Oncology
Adnan Majid, Fayez Kheir, Meghan Fashjian, Sumit Chatterji, Sebastian Fernandez-Bussy, Sebastian Ochoa, George Cheng, Erik Folch
RATIONALE: There is a paucity of evidence regarding the role of tunneled pleural catheters in pleural effusions caused by congestive heart failure that is refractory to medical management. OBJECTIVES: The aim of this study was to assess the feasibility of tunneled pleural catheter drainage for treatment of refractory pleural effusions associated with congestive heart failure, either when used alone or with concomitant talc pleurodesis performed during thoracoscopy...
February 2016: Annals of the American Thoracic Society
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