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Pleurodesis

One of the major symptoms of pleural mesothelioma is pleural effusion, which involves the accumulation of fluid in the pleural area. This buildup is especially common among those who have advanced mesothelioma. Patients may feel pain and become uncomfortable as this condition can severely restrict breathing.

Pleural effusion may also cause a rapid heartbeat and a number of other uncomfortable symptoms. While doctors often recommend a procedure known as thoracentesis to remove any excess fluid, individuals that have a reoccurring problem with accumulating fluid are sometimes advised to consider a surgical procedure known as pleurodesis.

What is a Pleurodesis?

Sometimes called chemical pleurodesis, this surgical procedure involves the introduction of talc into the area between the layers of the pleura. The talc is utilized to irritate the area, preventing further fluid accumulation. While in some cases the procedure does not eliminate accumulation all together, it does indeed provide acceptable results and may eliminate the need for further thoracentesis procedures, at least for a while.

While a pleurodesis may be uncomfortable and requires a longer recovery period than a standard thoracentesis, many pleural mesothelioma patients are quite pleased with the results. In addition, this procedure often eliminates frequent doctor or hospital visits and can greatly improve a patient’s quality of life while participate in everyday activities.

What Pleural Mesothelioma Patients Can Expect During a Pleurodesis

Depending on the patient’s overall condition, a pleurodesis can be performed at bedside or in a hospital operating room. When conducted in an operating room, a general anesthesia is used and the procedure is usually video-assisted. After receiving anesthesia, a small incision is made in the patient’s chest and a thoracoscope is inserted to remove any excess fluid.

The surgeon then introduces talc into the area between the pleural layers. A chest tube is later inserted to allow for complete drainage and may remain in place until the surgeon is pleased with the decrease in fluid. This may take a few days. A breathing tube is also generally inserted during the surgery and will be removed when it is determined the patient can breathe sufficiently on their own.

If the pleurodesis procedure is performed at bedside, a local anesthetic and sedative can be used. A chest tube is inserted in the lower part of the chest and the fluid drains through the tube with the help of a suction device. When it is determined that the fluid has been adequately removed, the talc will be inserted and the chest tube clamped to avoid losing the talc. The patient may be asked to change positions several times in order to distribute the talc evenly, resulting in successful surgery.

Regardless of how this procedure is performed, it can result in a great deal of pain, especially in the area where the chest tube or thoracoscope is inserted. Fever is also a common side effect of this procedure and deep breathing may be quite difficult for a while. A doctor will likely prescribe medications to address these issues. Over-the-counter anti-inflammatory medicines should be avoided.

Sources:

1. http://www.cancer.gov/dictionary/?CdrID=44294