ABSTRACT
The aim of this work is to compare the outcome and results of pleurodesis with injection of talc slurry versus pleurodesis with injection of autologous blood patch in management of persistent air leak complicating lung resection, decortication or spontaneous pneumothorax. This study was carried out from January 2003 till December 2006. The persistent air leak was a postoperative complication of lung resection or/and decortication or due to spontaneous pneumothorax. All the patients were considered to have persistent air leak if the air leak persisted for 7 days or more. The patients were divided into 2 groups, group I [autologous blood patch pleurodesis group] and group II [talc slurry pleurodesis group]. The Group I patients included 13 patients; 50 mL of autologous patch blood were injected intrapleurally for pleurodesis. Group II patients included 16 patients; 5 gm of asbestos-free talc slurry was injected intrapleurally for pleurodesis. There was no statistical significant difference between the mean ages of both groups, as the mean age of the blood group patients was 31 +/- 10 years, while it was 30 +/- 8 years for the talc slurry group patients. The mean prepleurodesis air leak period was [6.8 +/- 1 days VS 7.1 +/- 1 days respectively]. It was statistically non-significant There was no statistical significant difference in the mean post pleurodesis air leak period between the blood pleurodesis group patients and the talc slurry pleurodesis group patients [2.9 +/- 1.7 days VS 3.9 +/- 1.8 days respectively]. There was statistical significant difference in the mean dose of analgesics given postpleurodesis [139 +/- 60 mg VS 231 +/- 14 mg respectively], and in the mean postpleurodesis analgesic period [1.7 +/- 1 days VS 3.5 +/- 0.5 days respectively].There was no statistical significant difference between the 2 groups of patients in mean ICT period postpleurodesis [4.7 +/- 3.1 days VS 6.6 +/- 4 days respectively] and the mean hospital stay [7.5 +/- 3.7 days VS 9 +/- 4 days respectively]. Minor adverse effects occurred in blood plearodesis group of patients and talc slurry pleurodesis group of patients. Fever [23% VS 50%, respectively], empyema [8% VS 6%, respectively], chest pain [15% VS 56%, respectively], and recurrence [8% VS 13%, respectively]. Persistent air leak occurred in [8% VS 13%, respectively], and second dose pleurodesis in 1 patient of each group [8% VS 6%, respectively]. We concluded that in persistent air leak, pleurodesis with one of the 2 methods of pleurodesis [Autologous Blood Patch or Talc Slurry] is easy to perform, safe, available, and effective and does not add more costs. Acceptable minor adverse effects may occur more with talc slurry pleurodesis, but, it still effective and could be tolerated by the majority of patients