The Division of Thoracic Surgery at Boston Medical Center is here to help you and your family and to provide you with the most advanced and effective medical treatment—including pleurodesis—in New England. In addition to our expertise and state-of-the-art facilities, our caring staff offers a patient experience that is second to none. Our staff of surgeons and nurse practitioners works as a team to treat you and lead you on the path to recovery in the most comfortable way possible.
Pleurodesis is a therapy that we offer lung cancer patients to remove excess fluid, called pleural effusion, from the space between the lungs and chest wall that lines the lungs, or pleura. This fluid prevents the lungs from fully expanding when you breathe, causing shortness of breath. Pleural effusion is usually diagnosed using chest X-ray; a sample of the fluid may be taken to confirm its cause.
There are a few ways to perform pleurodesis. One is video-assisted thoracoscopy, a new, less invasive approach offered at BMC. Using a thoracoscope—a small, thin instrument with a light and lens—the surgeon locates the area to be treated, drains lung fluid and then inserts a talcum powder or antibiotic solution.
The solution circulates in the space between the pleura lining the chest wall and the lungs, causing some minor irritation and inflammation, which causes the tissues to stick together, eliminating the space. Further fluid buildup is prevented, allowing you to breathe easier. If the procedure isn’t successful, it may be repeated. Pleurodesis doesn’t treat lung cancer, but it can be very helpful in reducing symptoms.
How to Prepare
It’s important to follow any instructions your physician gives you to prepare for the procedure. In general instructions include:
- Not eating or drinking anything after midnight on the night before your procedure
- Bringing a list of all your prescription and over-the-counter medications, herbs and supplements with you to the hospital
- Arriving at the hospital one hour before your procedure
You may have a pre-admission appointment before your procedure, during which you’ll have routine blood tests, any necessary imaging and a talk with the anesthesiologist who will give you medicine during your procedure that will put you to sleep and ease pain.
What to Expect
We will place an intravenous (IV) line in a vein in your arm, so that medications and fluids can be given to you before, during and after the procedure. Once we have given you anesthesia and you are asleep, the surgeon will make one or two small incisions in your side and insert the thoracoscope. Other instruments are inserted into the other incisions.
This allows your surgeon to view the area in your chest on a monitor and guide the use of tools so that the fluid can be removed. We will then blow or spray a talc solution evenly over the lung and pleural surfaces. Your surgeon will remove the tools once this is finished and close the incisions. We’ll leave a tube in your chest for a day or two so that all of the fluid can drain.
Once the procedure is completed, a dressing is put over the incisions. It should remain in place for 24 to 48 hours.
We will give you instructions to care for your incision and prescribe or recommend pain medication, if necessary. Because anti-inflammatory drugs can prevent the irritation necessary for the treatment of pleural effusion, avoid using them for as long as your doctor advises.
You will have a follow-up appointment soon after your procedure, but call us in the meantime if you have concerns.