الفهرس 
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Abstract
Malignant Pleural Effusion (MPE) is defined as an accumulation of pleural fluid in which malignant cells are present. It is considered as a poor clinical indicator as it represents an advanced stage neoplasm with a median survival ranging from one to 12 months. Putting that in mind, together with the fact that, in as many as 20% of patients, MPE accounts for the first clinical presentation of malignancy; the management of such patients is predominantly palliative in nature, focused mainly on relieving the patients’ symptoms together with prevention of recurrence. This palliation requires the use of the most effective method that ensures both shortening of in hospital stay time and reducing outpatient clinic visits to the minimum together with being as much painless as possible and having the least reported complications. [3] [4] [5]
Excluding patients with expected poor survival of one month or less at time of diagnosis and those with trapped lungs; there is a consensus that chemical pleurodesis, i.e. chemical irritation of the pleural space to induce inflammation that closes the space by fibrosis, is the best definitive pleural intervention to be applied in patients with MPE who have re-expandable lung after thoracocentesis. Though many sclerosant agents have been proposed for this purpose, talc remains the most effective due to its high success rate together with being the cheapest and the most widely available agent. [8] [18] [22] [23] [24] [27]
Two methods of talc delivery are present. These are; talc slurry injection through chest tube thoracostomy and talc poudrage (insufflation) during thoracoscopic surgery. In our study, we aimed at identifying the method that best answers three main questions; (1) which method achieves the best results in regard to its success?; (2) which method inflects the least complications over the patient?; And (3) which method is associated with the minimum need for hospital stay and outpatient clinic visits?
The study sample was drawn from patients with malignant pleural effusion attending our emergency department and outpatient clinic in Suez Canal university hospitals between March 2019 and April 2020. We used