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Chemicals such as bleomycin, tetracycline (e.g., minocycline), [2] povidone-iodine, or a slurry of talc can be introduced into the pleural space through a chest drain. The instilled chemicals cause irritation between the parietal and the visceral layers of the pleura which closes off the space between them and prevents further fluid from accumulating. [3]
Pleurodesis is the obliteration of the pleural space, achieved by adhering the visceral pleura on the lung surface to the costal pleura of the chest wall. Adhesion is caused by inflammation and subsequent scarring of the pleural layers. Inflammation may be induced by either physical or chemical irritation.
A technique called pleurodesis can be used to intentionally create scar tissue within the pleural space, usually as a treatment for repeated episodes of a punctured lung, known as a pneumothorax, or for pleural effusions caused by cancer. While this procedure usually generates only limited scar tissue, in rare cases a fibrothorax can develop.
The surgical treatments usually involve pleurodesis (in which the layers of pleura are induced to stick together) or pleurectomy (the surgical removal of pleural membranes). [3] About 17–23 cases of pneumothorax occur per 100,000 people per year.
If the fluid is caused by tumors of the pleura, it may build up again quickly after it is drained. Sometimes anti-tumor medicines prevent further fluid buildup. If they do not, the doctor may seal the pleural space. This is called pleurodesis. Pleurodesis involves the drainage of all the fluid out of the chest through a chest tube.
Decortication is a medical procedure involving the surgical removal of the surface layer, membrane, or fibrous cover of an organ.The procedure is usually performed when the lung is covered by a thick, inelastic pleural peel restricting lung expansion.
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Video-assisted thoracoscopic surgery (VATS) is a type of minimally invasive thoracic surgery performed using a small video camera mounted to a fiberoptic thoracoscope (either 5 mm or 10 mm caliber), with or without angulated visualization, which allows the surgeon to see inside the chest by viewing the video images relayed onto a television screen, and perform procedures using elongated ...