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Talc pleurodesis for secondary pneumothorax in elderly patients with persistent air leak

  
@article{JTD26167,
	author = {Takuya Watanabe and Ichiro Fukai and Katsuhiro Okuda and Satoru Moriyama and Hiroshi Haneda and Osamu Kawano and Keisuke Yokota and Masayuki Shitara and Tsutomu Tatematsu and Tadashi Sakane and Risa Oda and Ryoichi Nakanishi},
	title = {Talc pleurodesis for secondary pneumothorax in elderly patients with persistent air leak},
	journal = {Journal of Thoracic Disease},
	volume = {11},
	number = {1},
	year = {2018},
	keywords = {},
	abstract = {Background: We herein report the usefulness of two types of talc pleurodesis for secondary pneumothorax of elderly patients with persistent air leak who have severe pulmonary emphysema.
Methods: We assessed 17 elderly patients with persistent air leak who received talc pleurodesis for secondary pneumothorax from April 2013 to March 2017. Thoracoscopic talc poudrage (TTP) (n=11) was performed in patients whose general condition was thought to sufficiently stable to tolerate for general anesthesia. Talc slurry pleurodesis (TSP) (n=6) via a chest tube was performed in patients whose general condition was thought to be insufficiently stable to tolerate general anesthesia.
Results: The median drainage period after pleurodesis was 6 days in patients who received TTP and  12 days in patients who received TSP. Complications associated with talc pleurodesis included atrial fibrillation (n=1) in the thoracoscopic poudrage group, while the slurry pleurodesis group showed chest pain (n=2), asthmatic attack (n=1), and pneumonia (n=1). All patients who received thoracoscopic poudrage were able to leave the hospital after removal of the chest tube. Five of the six patients who received slurry pleurodesis were able to leave the hospital, but one of them died of acute exacerbation of interstitial pneumonia (IP) on the 45th day after pleurodesis. The success rate was 94% (16/17). There were no cases of recurrence during the observation period.
Conclusions: TTP was deemed likely to be safe and effective for patients able to tolerate general anesthesia. In patients with IP, especially those treated with steroids, the indication of talc pleurodesis should be cautiously considered.},
	issn = {2077-6624},	url = {http://jtd.amegroups.com/article/view/26167}
}