Talc is a very effective pleural irritant, producing fibrosis and adhesion, but it has been associated with numerous side effects and complications. Twenty-seven patients underwent talc poudrage between March 1991 and August 1995. The patients
ranged in
age from 18 to 77 years. Of the 27patients who underwent the treatment, 18 had secondary spontaneous pneumothoraces, 2 had primary spontaneous pneumothoraces, 4 and traumatic pneumothoraces, 2 had empyema with bronchopleural fistula and 1 had
lung
cancer. All patients had continuous air leakage with multiple blebs or bullae or pulmonary emphysema. Blebs and bullae were eradicated with bullous exclusion technique using a Proximate RL stapler(Ethicone) for the treatment of pneumothoraces.
There
were no talc-related deaths or infections. Complications included mild fever in 40.7%(11/27), temporary elevation of hepatic enzyme in 14.8%(4/27), and delayed moderate pain requiring analgesics in 11.1%(3/27). There was no recurrence of air
leakage or
pneumothorax during the follow-up period of mean 27 months. This study suggests that proper selection of patients and talc poudrage will result in effective treatment with low morbidity.
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