Pleural effusion surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Prince Tano Djan, BSc, MBChB [2]

Overview

The primary role of surgical therapy is to drain the pleural fluid and prevent fluid from building up again. Therapeutic aspiration may be sufficient; larger effusions may require insertion of an intercostal drain. Therapeutic thoracentesis are done if the fluid collection is large and causing chest pressure, shortness of breath, or other breathing problems, such as hypoxia. Removing the fluid allows the lung to expand, making breathing easier. In people with cancer or infections, the effusion is often treated by using a chest tube for several days to drain the fluid.

Sometimes, small tubes can be left in the pleural cavity for a long time to drain the fluid. Repeated effusions may require chemical (talc, bleomycin, tetracycline/doxycycline) or surgical pleurodesis, in which the two pleural surfaces are attached to each other so that no fluid can accumulate between them.

Surgery

The primary role of surgical therapy is to drain the pleural fluid and prevent fluid from building up again.[1][2][3] Therapeutic aspiration may be sufficient; larger effusions may require insertion of an intercostal drain as seen in the video below. Therapeutic thoracentesis are done if the fluid collection is large and causing chest pressure, shortness of breath, or other breathing problems, such as hypoxia. Removing the fluid allows the lung to expand, making breathing easier. In people with cancer or infections, the effusion is often treated by using a chest tube for several days to drain the fluid.

Sometimes, small tubes can be left in the pleural cavity for a long time to drain the fluid. Repeated effusions may require chemical (talc, bleomycin, tetracycline/doxycycline) or surgical pleurodesis, in which the two pleural surfaces are attached to each other so that no fluid can accumulate between them.

References

  1. Koegelenberg CF, Vorster MJ (2015). "Chemical Pleurodesis for Malignant Pleural Effusion: How Far Have We Come in 80 Years?". Respiration 90 (5): 355-6. doi:10.1159/000441308. PMID 26484756.
  2. Hasan R, Khan OS, Aftabuddin M, Razzaque AM, Chowdhury GA (2016). "A Case of Massive Pleural Effusion: Pleurodesis by Bleomycin.". Mymensingh Med J 25 (2): 374-8. PMID 27277376.
  3. Porcel JM, Azzopardi M, Koegelenberg CF, Maldonado F, Rahman NM, Lee YC (2015). "The diagnosis of pleural effusions.". Expert Rev Respir Med 9 (6): 801-15. doi:10.1586/17476348.2015.1098535. PMID 26449328.





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