Uniportal Video-assisted Thoracoscopic Talc Pleurodesis in the Treatment of Malignant Pleural Effusions. Is Early Phase Talc Pleurodesis More Effective?

Abstract

Objective: VATS talk pleurodesis is an effective method for palliatively treating malignant pleural effusion (MPE). This study aimed to compare early and late-phase talc pleurodesis procedures and to determine the factors affecting the success of the uniportal VATS talc pleurodesis procedure. 
 Materials and Methods: The data of 58 patients who underwent uniportal VATS talc pleurodesis due to MPE were analysed retrospectively. The patients were divided into two groups as early-phase talc pleurodesis (n=23, 48.3%) and late-phase (n=25, 51.7%). Groups were compared using Pearson chi-square test and Mann-Whitney U tests.
 Results: Complications developed in 10 patients (17.2%). No significant difference was found between the early-phase talc pleurodesis and the late-phase pleurodesis regarding complication rate (p=0.905), durations of hospitalisation (p=0.821). It was observed that the early-phase talc pleurodesis procedure had higher success than the late-phase talc pleurodesis procedure (Odds ratio=1.425, 95%CI=0.307-6.624), although not statistically significant (p=0.06). It was determined that 86% of the patients who underwent early talc pleurodesis had no hospital readmission due to MPE within the first 3 months. 
 Conclusion: Uniportal VATS talc pleurodesis is a safe and effective treatment method for malignant pleural effusion, with low complication and high success rates. Early-phase talc pleurodesis procedure significantly reduces recurrent hospitalisations.