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Ann Thorac Surg 1997;64:285
© 1997 The Society of Thoracic Surgeons

Correspondence

Talc Slurry Versus Talc Insufflation Revisited

Anthony P. C. Yim, MD, M. Bashar Izzat, FRCS

Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Nt, Hong Kong e-mail:yimap{at}cuhk.edu.hk

To the Editor:

We read with interest the report by Cohen and associates [1] comparing tale slurry with talc insufflation in a porcine model. They concluded that both modalities of administration are equally effective in producing adhesions. This is what one might expect as talc is perhaps the most effective chemical sclerosant, with a greater than 90% success rate irrespective of mode of administration [2]. The dosage they used (5 g on each side) for a 35- to 50-kg pig, however, is proportionally twice the amount one would normally used clinically [2], and the experiment is carried out on supposedly normal lungs.

Along the same line, we recently reported a prospective, randomized study comparing talc insufflation with talc slurry in patients with symptomatic malignant pleural effusion (in the absence of trapped lungs) and arrived at the same conclusion that both routes of administration are equally effective [3]. We therefore advocate that talc slurry should be considered the procedure of choice because it is simple and can be performed by the bedside.

As the techniques for many thoracoscopic procedures are becoming standardized, one needs to focus more on prospective, randomized studies to define the true role of these procedures in thoracic surgery.

References

  1. Cohen RG, Shely WW, Thompson SE, et al. Tale pleurodesis: talc slurry versus thoracoscopic talc insufflation in a porcine model. Ann Thorac Surg 1996;62:1000–4.[Abstract/Free Full Text]
  2. Kennedy L, Sahn SA. Talc pleurodesis for the treatment of pneumothorax and pleural effusion. Chest 1994;106:1215–22.[Free Full Text]
  3. Yim APC, Chan ATC, Lee TW, Wan IYP, Ho JKS. Thoracoscopic talc insufflation versus talc slurry for symptomatic malignant pleural effusion. Ann Thorac Surg 1996;62:1655–8.[Abstract/Free Full Text]




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