PLEURAL TALC AT THORACOSCOPY IN THE TREATMENT OF A PNEUMOTHORAX

  • 1 January 1985
    • journal article
    • research article
    • Vol. 2  (1) , 25-29
Abstract
Talc therapy for a pneumothorax was considered particularly worthy of interest. Three year results obtained on a series of 109 pneumothoraces are reported. The indication for thoracoscopy were considered either for a chronic pneumothorax (failure of drainage after 8 days) or for a recurrent pneumothorax. This technique was performed under local anesthetic with talc therapy which allowed direct vision on the macroscopic lesions encountered. Patients were in hospital for a mean of 5 days. The results were as follows: Lung appearance was normal in 19%; Dystrophic bullae and giant bullae in 41%; blebs in 13%, a visible breach in 14% and diverse and anomalies bullae in 13%. The immediate failures with talc numbered 6 (5%) each time from the chronic pneumothorax group. They were treated surgically. There were 7 recurrences after talc therapy, 5 were partial recurrences requiring no further treatment and 2 total relapses were surgically treated. The radiological sequelae appeared minimal. On 5 occasions pleural discomfort hindered the diaphragmatic movement, in the other cases the radiological sequelae consisted of discrete pleural thickening. Forty-two patients had respiratory function testing and no abnormalities were noted. The failures or recurrences in the talc treated patients were all in the recurrent pneumothorax and were only 13 cases (12%). Thoracoscopy is a treatment of choice in the treatment of recurrent pneumothorax, and often replaces surgery. In certain cases (pneumothorax in respiratory failure) it is only possible treatment.

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