What is pleurodesis?
Pleurodesis refers to getting the ‘pleura’ – which is the lining of the lungs – to stick together. In the chest there are two layers to the pleura, one against the ribs and one on the surface of the lung. Normally in every person there’s a bit of fluid that allows the lung to slide against the chest wall when you breathe in and breathe out. For some people, this space becomes much larger due to a build up of fluid or air. Pleurodesis surgery may be performed to help bring the layers back together and reduce the space. Watch the video to hear more from Director of Cardiothoracic Surgery at The Prince Charles Hospital, Dr Rishendran Naidoo or read on below.
How is pleurodesis surgery performed?
Pleurodesis surgery is typically performed as keyhole surgery with two or three little holes (about 1.5cm) on the side of the chest where a telescope is inserted into the chest cavity. If you have fluid build up, this will be drain. The method used to get the lung to stick to the chest wall depends on a few things such as your age and the cause.
Dr Naidoo says young people would tend to have a mechanical pleurodesis. This is where the lining of the chest wall is ‘scratched’ with a small piece of sandpaper, or lining of the chest wall is peeled to allow the lung to stick.
For people with cancer, suspected cancer or older people, it’s more common for a sterile form of talcum powder, called ‘talc’ to be sprayed on the chest wall and allowed to circulate for a few hours before being drained. This causes inflammation so the lung will stick to the chest wall.
At the end of the surgery a chest rain will be inserted which will remain in place for up to 5 days. When it’s removed a chest x-ray will confirm that the lung has expanded and stuck to your chest wall.
Why is pleurodesis surgery performed?
Dr Naidoo says the pleurodesis surgery is performed for a variety of reasons but commonly for either fluid or air build up around the lungs.
Pleural effusion
You may be recommended pleurodesis surgery if you have excess fluid around your lungs. This may be caused by an inflammatory condition or a tumour. The cause of the fluid build up will determine if you need pleurodesis surgery. Other options may include chest drainage or non-steroidal anti-inflammatory drugs.
Pneumothorax
A collapsed lung is called a pneumothorax. This typically happens when too much air enters the space around the lungs creating increased pressure. The severity depends on how much air is trapped. If you experience multiple episodes of this, a pleurodesis may be considered to reduce the gap and minimise the chance of it happening again.
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