• Cecilia Menna, Claudio Andreetti, Mohsen Ibrahim, Giulio Maurizi, Camilla Poggi, Rocco Barile, Francesco Cassiano, and Erino A Rendina.
• Division of Thoracic Surgery, "G. Mazzini" Hospital of Teramo, Faculty of Medicine and Surgery, University of L'Aquila, Piazza Italia 1, 64100 Teramo, Italy.
• Biomed Res Int. 2013 Jan 1; 2013: 295890.

BackgroundChemical pleurodesis is the procedure of choice in the management of recurrent malignant pleural effusions (MPE). Talc is probably the most effective sclerosant, with a success rate of 80%. The aim of this study is to demonstrate the effectiveness of silver nitrate solution (SNS) pleurodesis after an unsuccessful thoracoscopic talc poudrage.MethodsBetween 2011 and 2013 one hundred and nine patients with unilateral MPE underwent thoracoscopic talc poudrage. Seventeen patients who did not obtain a successful pleurodesis via thoracoscopic procedure were considered for an SNS slurry. The pleural injectate consisted of 100 mL 1% SNS with 10 mL of lidocaine (100 mg/5 mL). The SNS procedure was undertaken once and repeated with the same dose in 5 patients.ResultsThe duration of follow-up period was 30 days. Subjective pain was low and the same before and after SNS procedure (P value = NS). The mean daily fluid drainage was statistically different (P = 0.001) comparing values before (597.0 ± 122.8 mL) and after SNS procedure (109.1 ± 22.3 mL). After 30 days from SNS procedure recurrence of pleural effusion was observed in 2 patients (11%).ConclusionsThe present study demonstrates that SNS is an effective agent for producing pleurodesis after a failed thoracoscopic talc poudrage.

19 keywords...

hide…