Video Assisted Thoracoscopic Talc Pleurodesis : A single center experience using cost saving measures

Amandeep Singh Nar, MBBS, MS, FMAS, Ashvind Bawa, MBBS, MS, FMAS, Atul Mishra, MBBS, MS, FRCS

Dayanand Medical College and Hospital, Ludhiana

Introduction

Video-assisted thoracoscopic talc pleurodesis is a highly effective technique to manage recurrent pneumothorax or pleural effusion.Surgical treatment using thoracoscopy may hasten postoperative recovery and reduce hospital stay.

Methods

Patients with recurrent pneumothorax or pleural efffusion were taken up for VATS (thoracoscopic) talc pleurodesis under general anesthesia using single lung ventilation with use of double lumen tube. They were subjected to diagnostic aspiration of pleural fluid and biopsy of primary pathology. Pleurodesis using medical grade talc using mucous sucker on an insufflator technique was used for uniform and effective talc distribution over visceral and parietal pleural surfaces and the diaphragm.

Results

A retrospective analysis of a consecutive series of thoracoscopic pleurodesis with talc was performed. 40 patients had been taken up for the procedure from January 2007 till December 2010. In 18 patients, pleurodesis was performed for malignant pleural effusions. 15 cases were of spontaneous pneumothorax and 7 were of recurrent pneumothorax. The mean stay of these patients in the hospital was 10 days. All drains were removed from 5th till 7th day. No cases of respiratory distress post surgery were reported. Recurrence was encountered in 5 patients mostly belonging to the malignant effusion group.

Conclusion

Video-assisted thoracoscopic talc pleurodesis is a highly effective technique to manage recurrent pneumothorax or pleural effusion. Using our indigenous technique for uniform talc distribution it can be made available to vast populations for use as a cost effective method.


Session: Poster Presentation

Program Number: P568

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