Comparative study of talc poudrage versus pleural abrasion for the treatment of primary spontaneous pneumothorax

• Published in: Interactive cardiovascular and thoracic surgery 2012-07, Vol.15 (1), p.81-85
• Main Authors: Moreno-Merino, Sergio, Congregado, Miguel, Gallardo, Gregorio, Jimenez-Merchan, Rafael, Trivino, Ana, Cozar, Fernando, Lopez-Porras, Marta, Loscertales, Jesus
• Format: Article
• Language: English
• Subjects: Adult; Female; Humans; Length of Stay; Male; Original; Pleurodesis - adverse effects; Pleurodesis - methods; Pneumothorax - therapy; Recurrence; Retrospective Studies; Risk Assessment; Risk Factors; Spain; Surgical Sponges; Talc - administration & dosage; Talc - adverse effects; Thoracic Surgery, Video-Assisted; Time Factors; Treatment Outcome
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivs027

Primary spontaneous pneumothorax is a pathology mainly affecting healthy young patients. Clinical guidelines do not specify the type of pleurodesis that should be conducted, due to the lack of comparative studies on the different techniques. The aim of this study was to compare talc poudrage and pleural abrasion in the treatment of spontaneous pneumothorax. A retrospective comparative study was performed, including 787 patients with primary spontaneous pneumothorax. The 787 patients were classified into two groups: Group A (pleural abrasion) n = 399 and Group B (talc pleurodesis) n = 388. The variables studied were recurrence, surgical time, morbidity and in-hospital length of stay. Statistical analysis was done by an unpaired t-test and Fisher's exact test (SSPS 18.0). Statistically significant differences were observed in the variables: surgical time (A: 46 ± 12.3; B: 37 ± 11.8 min; P < 0.001); length of stay (A: 4.7 ± 2.5; B: 4.3 ± 1.8 days; P = 0.01); apical air camera (A: 25; B: 4; P < 0.001); pleural effusion (A: 6; B: 0; P = 0.05). Talc poudrage shows shorter surgical times and length of stay, and lower re-intervention rates. Morbidity is lower in patients with talc poudrage. Statistically significant differences were not observed in recurrence, persistent air leaks, atelectasis and haemothorax.