TREATMENT OF MALIGNANT PLEURAL EFFUSIONS BY TALC POUDRAGE

Abstract

The operation of talc poudrage here described is designed to stop persistent pleural effusions in cases of incurable cancer. The incision permits exploration of the affected hemithorax and can be extended if the lesion is found to be resectable. If it is not resectable, the pleural surfaces are generously dusted with sterile talc (USP) and two fenestrated intercostal drainage tubes are inserted through separate stab wounds; the latter permit application of suction to maintain complete obliteration of the pleural space for 48 to 72 hours. Two cases are described in detail, and the results of 19 operations are described. Thirteen were for primary pulmonary neoplasms; three were for metastatic carcinoma of the breast. In every instance dyspnea was relieved and recurrence of the effusion was prevented. There were no complications or deaths attributable to the operation.