Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 May 4;16(1):125.
doi: 10.1186/s13019-021-01475-1.

Complications of thoracoscopic talc insufflation for the treatment of malignant pleural effusions: a meta-analysis

Wen Zhang #  1 , Yun-Long Zhao #  1 , Shao-Jun Li  1 , Ying-Nan Zhao  1 , Nan-Nan Guo  2 , Bo Liu  3
Affiliations
Review

Complications of thoracoscopic talc insufflation for the treatment of malignant pleural effusions: a meta-analysis

Wen Zhang et al. J Cardiothorac Surg. .

Abstract

Background: Talc pleurodesis is an effective treatment for malignant pleural effusions (MPEs). This study was designed to estimate complication rates of thoracoscopic talc insufflation.

Methods: Literature search was conducted in electronic databases and studies were selected if they reported complication rates of thoracoscopic talc insufflation in cancer patients with MPEs. Meta-analyses of proportions were performed to obtain incidence rates of complications.

Results: Twenty-six studies (4482 patients; age 62.9 years [95% confidence interval (CI): 61.5, 64.4]; 50% [95% CI: 43, 58] females) were included. Intraoperative, perioperative, 30-day, and 90-day mortality rates were 0% [95% CI: 0, 1], 2% [95% CI: 0, 4], 7% [95% CI: 3, 13] and 21% [95% CI: 5, 43] respectively. Incidence rates [95% CI] of various complications were: pain (20% [1, 2]), fever (14% [3, 4]), dyspnea (13% [5, 6]), pneumothorax (6% [7, 8]) pneumonia (4% [0, 12]), emphysema (3% [3, 7]), prolonged air leakage (3% [0, 7]), prolonged drainage (3% [9, 10]), thromboembolism (3% [9, 11]), lung injury (2% [7, 12]), respiratory insufficiency (2% [0, 5]), re-expansion pulmonary edema (1% [0, 3]), empyema (1% [0, 2]), respiratory failure (0% [0, 1]), and acute respiratory distress syndrome (ARDS; 0% [0, 1].

Conclusions: Whereas pain and fever were the most frequent complications of thoracoscopic talc insufflation, the incidence of ARDS was low. Pneumothorax, pneumonia, emphysema, prolonged air leakage, pulmonary embolism, arrythmia, re-expansion pulmonary edema, and empyema are important complications of thoracoscopic talc insufflation.

Keywords: Malignant pleural effusions; Pleurodesis; Talc insufflation; Thoracoscopy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
A flowchart of study screening and selection process
Fig. 2
Fig. 2
A forest graph showing the incidence rates of dyspnea, emphysema, respiratory insufficiency, respiratory failure, and acute respiratory distress syndrome after thoracoscopic talc insufflation
Fig. 3
Fig. 3
A forest graph showing the complication rates of persistence of fluid, pneumothorax, prolonged drainage, prolonged air leakage, lung injury, re-expansion pulmonary edema, pulmonary edema, and bleeding after thoracoscopic talc insufflation
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Donnenberg AD, Luketich JD, Dhupar R, Donnenberg VS. Treatment of malignant pleural effusions: the case for localized immunotherapy. J Immunother Cancer. 2019;7(1):110. doi: 10.1186/s40425-019-0590-4. - DOI - PMC - PubMed
    1. Antony VB, Jantz MA. Pleural effusions. Malignant Pleural Effusions. Encyclopedia Respir Med. 2006; 10.1016/B0-12-370879-6/00304-5.
    1. American Thoracic Society Management of malignant pleural effusions. Am J Respir Crit Care Med. 2000;162(5):1987–2001. doi: 10.1164/ajrccm.162.5.ats8-00. - DOI - PubMed
    1. Dresler CM. Systemic distribution of talc. Chest. 1999;166(1):266. doi: 10.1378/chest.116.1.266. - DOI - PubMed
    1. Fortin M, Tremblay A. Pleural controversies: indwelling pleural catheter vs. pleurodesis for malignant pleural effusions. J Thorac Dis. 2015;7(6):1052–1057. - PMC - PubMed

MeSH terms