Lung function 22-35 years after treatment of idiopathic spontaneous pneumothorax with talc poudrage or simple drainage

Our plain-English summary of Lung function 22-35 years after treatment of idiopathic spontaneous pneumothorax with talc poudrage or simple drainage, by P. Lange, J. Mortensen, S. Groth (Thorax, 1988).

The study

• Authors: P. Lange, J. Mortensen, S. Groth
• Journal: Thorax
• Published: 1988;43(7):559-61
• Cited by: 105 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The long term effects on lung function of treatment of idiopathic spontaneous pneumothorax by talc poudrage or simple chest drainage were assessed in 114 patients. Subjects were studied 22-35 years after their first pneumothorax with measurement of static and dynamic lung volumes. Eighty patients had been treated with talc pleurodesis and 34 with simple pleural drainage. At the follow up examination 17 had died from what appear to be unrelated causes and two had emigrated. Of the remainder, 75 participated fully in the study, 14 completed a postal questionnaire, and six failed to respond. The group treated with talc poudrage showed a mild restrictive impairment of lung function with a mean total lung capacity (TLC) of 89% predicted. In subjects treated with simple drainage mean TLC was 96% predicted. One subject treated with talc poudrage had extensive pleural calcification and a substantial reduction in lung function (TLC 58% predicted) with some evidence of lung fibrosis. None of the subjects had developed a mesothelioma. We conclude that, although talc poudrage may cause a mild restrictive impairment of lung function and pleural thickening on the chest radiograph, the long term outlook is good.

In plain English

This Danish follow-up study examined 114 consecutive patients treated in Copenhagen in 1951-63 for a first idiopathic spontaneous pneumothorax (collapsed lung without prior lung disease). Eighty were treated with talc poudrage (talc pleurodesis) and 34 with simple chest drainage. By 1985, 22-35 years later, 17 had died and two had emigrated; 75 had lung function tests and chest X-rays. Mean total lung capacity was 89% of predicted in the talc group and 96% in the drainage group, a statistically significant difference. Pleural thickening appeared on 51 of 75 X-rays, with no significant difference between groups (76% and 55%). One woman, treated with talc on one side and hypertonic glucose on the other, had extensive pleural calcification, total lung capacity of 58% predicted and signs of lung fibrosis. Three deaths were from lung cancer, and no subject had developed mesothelioma. The authors noted that asbestos contamination of talc had been suggested as a mesothelioma risk and that their follow-up could not entirely exclude it, as latency has exceeded 40 years in some studies. They concluded the long-term outlook was good.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Long-term follow-up study of a consecutive series of patients, comparing two initial treatments (talc poudrage versus simple drainage)
• Who was studied: 114 consecutive patients (99 men, 15 women) treated at the chest clinics at Øresundshospitalet and Bispebjerg Hospital, Copenhagen, Denmark, for a first episode of idiopathic spontaneous pneumothorax during 1951-63; traced in autumn 1985, 22-35 years later
• Exposure: Talc poudrage (talc pleurodesis) in 80 patients (60 for the first episode, 20 for a relapse after drainage; group 1) versus simple pleural drainage only in 34 patients (group 2). The talc was not analysed for asbestos in this study.
• Main results:
  • At follow-up, 17 of the 114 had died and two had emigrated. Of the remaining 95, 75 took part fully, 14 completed a postal questionnaire only, and six did not respond.
  • Mean total lung capacity (TLC) was 89% of predicted in the talc poudrage group and 96% of predicted in the simple drainage group.
  • The talc poudrage group (group 1) had significantly lower TLC values than the simple drainage group (group 2).
  • 51 of the 75 patients who had a chest radiograph showed pleural thickening. There was no significant difference between the talc group (76%) and the drainage group (55%).
  • Subjects with pleural thickening had significantly lower TLC (89% predicted) and VC (80% predicted) than those without pleural thickening (TLC 98% predicted, VC 88% predicted).
  • One talc-treated subject had extensive pleural calcification, TLC of 58% predicted, and some evidence of lung fibrosis.
  • This subject, a woman, had talc pleurodesis on the left side and hypertonic glucose pleurodesis on the right side.
  • Of the 17 deaths, three were from lung cancer.
  • None of the subjects had developed a mesothelioma.
• The authors' conclusion: The authors concluded that, although talc poudrage may cause a mild restrictive impairment of lung function and pleural thickening on the chest radiograph, the long-term outlook is good.
• Limitations the authors state:
  • The authors noted that asbestos pollution of talc has been suggested as a risk factor for mesothelioma. Because the latent period for mesothelioma has been longer than 40 years in some studies, they stated that their 22-35 year follow-up does not entirely exclude the possibility of asbestos pollution of the talc.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Talc and vermiculite.

Medical terms in this study, explained in our Lexicon: Idiopathic, Pneumothorax, Talc, Talc Pleurodesis, Total Lung Capacity (TLC), Pleural Calcification, Fibrosis, Mesothelioma.

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