Pleural effusion surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Surgery

Treatment aims to:

  • Remove the fluid.
  • Prevent fluid from building up again.
  • Treating the cause of the fluid buildup.
  • Therapeutic thoracentesis.

Therapeutic aspiration may be sufficient; larger effusions may require insertion of an intercostal drain (either pigtail or surgical). Therapeutic thoracentesis are done if the fluid collection is large and causing chest pressure, shortness of breath, or other breathing problems, such as low oxygen levels. Removing the fluid allows the lung to expand, making breathing easier. Treating the cause of the effusion then becomes the goal.

For example, pleural effusions caused by congestive heart failure are treated with diuretics (water pills) and other medications that treat heart failure. Pleural effusions caused by infection are treated with appropriate antibiotics. 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.

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