The effect of silver nitrate pleurodesis after a failed thoracoscopic talc poudrage

Biomed Res Int. 2013;2013:295890. doi: 10.1155/2013/295890. Epub 2013 Sep 1.


Background: Chemical 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.

Methods: Between 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.

Results: The 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%).

Conclusions: The present study demonstrates that SNS is an effective agent for producing pleurodesis after a failed thoracoscopic talc poudrage.

Publication types

  • Clinical Trial

MeSH terms

  • Drainage
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pleural Effusion, Malignant / therapy*
  • Pleurodesis*
  • Radiography, Thoracic
  • Silver Nitrate / administration & dosage*
  • Silver Nitrate / therapeutic use*
  • Talc / administration & dosage*
  • Talc / therapeutic use*
  • Thoracoscopy*
  • Treatment Failure


  • Talc
  • Silver Nitrate