Predictors of Pleural Adhesion Formation and Success of Pleurodesis in Patients With Pleural Effusion

摘要

Pleural adhesions can complicate thoracoscopic pleurodesis. We undertook this study to determine predictors of pleural adhesion formation and success of pleurodesis in patients undergoing medical thoracoscopy and talc poudrage. Patients undergoing medical thoracoscopy at Georgetown University Medical Center between August 1995 and March 2002 were retrospectively studied. Charts were reviewed for demographics, number of thoracenteses, effusion duration, effusion malignancy, origin of any underlying malignancy, thoracic irradiation, presence and extent of pleural adhesions, and the success of pleurodesis. A total of 89 patients were identified with complete medical records. Overall, only effusion duration of >= 5 months predicted adhesion formation (P = 0.032) and extent (P = 0,0.38), With malignant effusions, duration of effusion >= 5 months and mean effusion duration predicted adhesion formation (P = 0.020 and 0.045, respectively) and extent (P = 0.037 and 0,018, respectively). With underlying breast cancer, duration of effusion >= 5 months and mean duration of effusion predicted adhesion formation (P = 0.008 and 0.037, respectively) and extent (P = 0.011 and 0.035, respectively). Regression analysis demonstrated that only duration of effusion of >= 5 months predicted adhesions (odds ratio, 13.74; 95% confidence interval, 1.26-150.15). There were no predictors of pleurodesis success. The duration of effusion regardless of the etiology, especially if >= 5 months, is associated with formation of thick pleural adhesions.