Pleurodesis is a therapy that we offer for lung cancer patients to remove excess fluid—called pleural effusion—from the space between the lungs and chest wall that line the lungs (pleura). This fluid prevents the lungs from fully expanding as you breathe, causing shortness of breath. Pleural effusion is usually diagnosed by means of a chest x-ray, and a sample of the fluid may be taken to confirm its cause.
There are a few ways to perform pleurodesis.
One such way is video-assisted thoracoscopy, a new, less invasive method that we offer at BMC. Using a thoracoscope, a small, thin instrument with a light and lens, your surgeon will locate the area to be treated, drain your lung fluid, and then insert a talcum powder or antibiotic solution. This solution will circulate in the space between the pleura lining the chest wall and the lungs, causing some minor irritation and inflammation, which then causes the tissues to stick together, eliminating the space. Further fluid buildup is thereby prevented, allowing you to breathe easier. If the procedure is not successful, it may be repeated.
Pleurodesis does not treat lung cancer, but it can be a very helpful tool in reducing symptoms.
PleurX Catheter: The PleurX catheter is a thin, flexible tube that is placed in the pleural space to drain the fluid buildup associated with pleural effusion. Traditionally, treatment for chronic pleural effusion has required patients to remain in the hospital. The PleurX catheter allows you to manage your pleural effusion at home. The device consists of a catheter that is placed in the pleural space through a small incision. The catheter is connected to a vacuum bottle. When you open a valve at the end of the catheter, fluid drains into the vacuum bottle.
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.
Recovery Process
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.