Center for Thoracic Oncology
Pleurodesis or Pleural Effusion
The Center for Thoracic Oncology at Boston Medical Center is dedicated to providing you and your family with the most advanced and effective medical treatment 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 compassionate surgeons, physician assistants, nurse practitioners and surgical nurses work 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 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.
How to Prepare
It is important to follow any preparatory instructions given to you by your physician. These instructions generally include:
- Refraining from eating or drinking anything after midnight on the night before
- Bringing a list of all of your prescription and over-the-counter medications, herbs, and supplements
- Arriving one hour prior to your procedure time
You may have a pre-admission appointment beforehand, in which you will have routine blood testing, any heart or esophageal imaging, and consultation with the anesthesiologist, who will give you medicine during your procedure that puts you to sleep and eases pain.
What to Expect
First we will place an intravenous (IV) line in your arm, so that medications and fluids may be administered before, during, and after the procedure. Once you have been given anesthesia and 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 within your chest on a monitor, and guide the use of tools so that the fluid can be removed. The talc solution is then blown or sprayed evenly over the lung and pleural surfaces. Your surgeon will remove the tools once this process is complete, and close the incisions. A tube will be left in your chest for a day or two to allow complete evacuation of all fluid.
Once the procedure is complete, a dressing will be applied over the incisions. It should be left in place for 24 to 48 hours. We will give you instruction on how to care for your incision and prescribe or recommend any pain medication if necessary. Please avoid anti-inflammatory drugs for a period of time specified by your physician, as they can prevent the irritation that is necessary for the resolution of pleural effusion. You will likely have a follow-up appointment soon after your procedure. Please call us if you have concerns.