Review: thoracoscopic pleurodesis with talc may be the optimal technique in patients with malignant pleural effusions.

M e t h o d s Data sources: Cochrane Controlled Trials Register (Issue 4, 2001), MEDLINE (1980 to June 2002), EMBASE/Excerpta Medica (1980 to May 2002), bibliographies of relevant studies, and contacting experts. Study selection and assessment: Randomized controlled trials (RCTs) in any language of patients > 16 years of age having pleurodesis for pleural effusion in the context of metastatic cancer or a malignant process leading to pleural effusion that compared any sclerosant with other sclerosants, or thoracoscopic pleurodesis with bedside pleurodesis. 2 reviewers independently assessed studies for quality. Outcomes: Effectiveness of pleurodesis (nonrecurrence of effusion) and adverse events.