Mesothelioma Pleurodesis

Several medical conditions including malignant pleural mesothelioma can cause lymphatic fluid to accumulate between the lining of the chest wall (parietal pleura) and the lining of the lungs (visceral pleura). This is known as pleural effusion; symptoms include dyspnea (shortness of breath) as well pain due to the pressure exerted on the body's organs.
Pleurodesis is a treatment for patients that have received a pleural effusion diagnosis. A chemical substance (usually talc) in injected into the space between the pleural membranes using a large needle or a thoracoscope (a tube that enters the chest). This causes irritation of the pleural membranes, which become inflamed and bond together as a result, eliminating this space so that fluid cannot accumulate. Pleurodesis is not a treatment of the mesothelioma cancer itself however.
Pleurodesis may be performed at the bedside or in the operating room, depending on the condition of the patient. When done as a bedside procedure a local anesthetic is administered. During the procedure, mesothelioma doctors will insert a large needle into the chest cavity. When this mesothelioma surgery is performed in the operating room, it is done under general anesthetic with the use of video-assisted thoracoscopy, which helps the surgeon in guiding the needle.
In both cases, the tip of the needle is inserted into the pleural space between the membranes and attached to a drainage tube. This drainage is done slowly in order to avoid a drastic reduction in blood pressure. Once the excess lymphatic fluid is removed, the doctor uses the needle in order to inject the talc solution into the pleural space. This drain is clamped in place for an hour; afterwards, the doctor may attach the drain to a suctioning device in order to ensure that the pleura layers bond properly.