Efficacy of talc pleurodesis for primary spontaneous pneumothorax: post surgery (intervention on lung)
| Study author | Year | Study design | Total number of cases | Intervention (n) | Cointervention | Intervention recurrence rate (95% CI) | Control/reference arm (n)? | Control/reference recurrence rate (95% CI) | Follow-up period (months) | OR (vs control/reference) (95% CI) |
|---|---|---|---|---|---|---|---|---|---|---|
| RCT | ||||||||||
| Chung22 | 2008 | RCT (3 arms) | 141 | Talc and dextrose (42) | VATS+bleb resection or electrocoagulation | 2.4% (0.3% to 17.3%) | Drainage only (50) | 6.0% (1.9% to 19.3%) | 24MN, 20MN | 0.38 (0.04 to 3.82) |
| Dextrose only (49) | “ | 2.0% (0.3% to 14.8%) | 18MN | 0.33 (0.03 to 3.25) | ||||||
| Prospective series | ||||||||||
| Ramos-Izquierdo23 | 2010 | Prospective series | 133 | Talc poudrage (133) | VATS±bleb electrocoagulation | 3.2% (1.2% to 8.7%) | – | – | 36MN | – |
| Dubois24 | 2010 | Prospective series | 72 | Talc poudrage (72) | VATS+apical bullectomy | 0% (0.0% to 4.2%) | – | – | 12MN | – |
| Retrospective case series (with comparator group) | ||||||||||
| Moreno-Merino26 | 2012 | Retrospective case series | 787 | Talc poudrage (388) | VATS+bullectomy | 1.5%* (0.7% to 3.5%) | Pleural abrasion† (399) | 4.0%* (2.4% to 6.6%) | Unclear | 0.38 (0.15 to 0.97) |
| Janssen29 | 1994 | Retrospective case series | 44 | Talc poudrage (21) | VATS±bleb resection or electrocoagulation‡ | 0% (0.0% to 14.3%) | VATS-bullectomy (23)‡ | 8.7% (2.0% to 37.1%) | >18 | 0.20 (0.01 to 4.42) |
| Retrospective case series (no comparator group) | ||||||||||
| Cardillo25 | 2006 | Retrospective case series | 861 | Talc poudrage (861) | VATS±bullectomy | 1.7%§ (1.0% to 3.0%) | – | – | 53MN | – |
| Margolis27 | 2003 | Retrospective case series | 156 | Talc poudrage (156) | VATS+bleb resection | 0% (0.0% to 1.9%) | – | – | 62MD | – |
| Mármol Cazas28 | 2011 | Retrospective case series | 130 | Talc poudrage (130) | VATS±bullectomy | 3.1% (1.1% to 8.3%) | – | – | 10MN | – |
*Includes early treatment failures requiring reintervention.
†Historical comparison.
‡Thoracoscopic talc poudrage was performed in patients with normal pleura or bullae <2 cm diameter, bullectomy was performed in those with bullae >2 cm.
§Excluded 56 lost to follow-up.
MD, median; MN, mean; RCT, randomised controlled trial; VATS, video-assisted thoracic surgery.