Efficacy of talc pleurodesis on spontaneous pneumothorax (PSP and SSP): medically and surgically treated
| Study author | Year | Study design | Total number of cases | PSP or SSP? (n) | Intervention (n) | 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) |
|---|---|---|---|---|---|---|---|---|---|---|
| RCTs—medical | ||||||||||
| Almind6 | 1989 | RCT* | 96* | PSP (71) SSP (25)* | Talc via chest drain (29) | 8.3% (2.0% to 35.4%) | Drainage only (34) | 36.0% (15.9% to 81.5%) | 55MN | 0.16 (0.03 to 0.85) |
| Prospective series—medical | ||||||||||
| Noppen32 | 1997 | Prospective case series | 54 | PSP (31) SSP (23) | Talc at thoracoscopy (54)±bleb electrocoagulation | 7.4% (2.7% to 20.5%) | – | – | 18MN | – |
| Milanez33 | 1994 | Prospective case series | 18 | PSP (15) SSP (3) | Talc at thoracoscopy (18) | 5.6% (0.7% to 41.7%) | – | – | 38.5MN | – |
| Retrospective case series—medical (with comparator group) | ||||||||||
| Aihara36 | 2011 | Retrospective case series | 36 | PSP (0) SSP (36) | Talc via chest drain (14) | 24.1% (6.0% to 76.8%) | Blood (22) | 36.4% (15.3% to 86.7%) | 15MN | 0.48 (0.10 to 2.24) |
| Retrospective case series—medical (no comparator group) | ||||||||||
| Van de Brekel34 | 1993 | Retrospective case series | 356† | Unclear | Talc at thoracoscopy (356) | 12.1% (8.8% to 16.6%) | † | † | 12–240 | – |
| Weissberg37 | 1993 | Retrospective case series | 122 | Unclear | Talc via chest drain (122) | 13.3% (7.7% to 22.9%) | – | – | Unclear | – |
| Tschopp35 | 1997 | Retrospective case series | 93 | PSP (65) SSP (28) | Talc at thoracoscopy (93) | 16.1% (9.3% to 28.0%) | – | – | 60 | – |
| Nandi30 | 1980 | Retrospective case series | 24 | PSP (0) SSP (24) | Talc via chest drain (24) | 0% (0.0% to 12.5%) | – | – | 2–24 | – |
| Pletinckx31 | 2005 | Retrospective case series | 20 | PSP (5) SSP (15) | Talc at thoracoscopy (54)±bleb resection | 0% (0.0% to 15.0%) | – | – | – | |
| Retrospective case series—surgical (with comparator group) | ||||||||||
| Shaikhrezai38 | 1984 | Retrospective case series | 519 | PSP (444) SSP (75) | VATS+bullectomy+talc poudrage (246) | 1.2% (0.4% to 3.8%) | VATS+bullectomy+abrasion (273) | 2.9% (1.5% to 5.9%) | 73MD | 0.41 (0.11 to 1.56) |
| Kim40 | 2011 | Retrospective case series | 61 | PSP (0) SSP (61) | VATS+bullectomy+talc (22) | 4.5% (0.6% to 33.8%) | Drainage+talc via drain (39) | 30.8% (15.6% to 60.7%) | Unclear | 0.11 (0.01 to 0.89) |
| Retrospective case series—surgical (no comparator group) | ||||||||||
| de Campos39 | 2001 | Retrospective case series | 49 | Unclear | VATS+bullectomy+talc (49) | 2.0% (0.3% to 14.8%) | – | – | 24–60 | – |
Follow-up range shown if no average given.
*RCT had three arms (total numbers include tetracycline arm, n=33).
†Thoracotomy and bullectomy were performed in those with bullae >2 cm at thoracoscopy—not included in analysis.
MD, median; MN, mean; PSP, primary spontaneous pneumothorax; RCT, randomised controlled trial; SSP, secondary spontaneous pneumothorax; VATS, video-assisted thoracic surgery.