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Pleurodesis is a medical procedure in which part of the pleural space is artificially obliterated. [1] It involves the adhesion of the visceral and the costal pleura. The mediastinal pleura is spared.
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.
Video-assisted thoracoscopic surgery (VATS) is a surgical operation involving thoracoscopy, usually performed by a thoracic surgeon using general or local/regional anaesthesia with additional sedation as necessary.
If a chest tube is already in place, various agents may be instilled through the tube to achieve chemical pleurodesis, such as talc, tetracycline, minocycline or doxycycline. Results of chemical pleurodesis tend to be worse than when using surgical approaches, [ 12 ] [ 15 ] but talc pleurodesis has been found to have few negative long-term ...
For this reason, more permanent treatments are usually used to prevent fluid recurrence. Standard treatment involves inserting an indwelling pleural catheter and pleurodesis. [16] However, this treatment requires an inpatient stay of approximately 2–7 days, can be painful and has a significant failure rate.
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 ...
The mortality of surgery is less than 1% overall, but rises to 4-6% in the elderly. Other factors predicting poorer surgical outcomes include intraoperative complications, incomplete surgery, lung disease beyond the fibrothorax being treated, and specific causes of fibrothorax such as asbestosis. [10]
Additionally, the amount of pleural fluid produced can overcome pleurodesis, causing it to fail. [9] Complications may include empyema, sepsis, and septic shock. Chest tubes and intercostal chest drains are contraindicated, as they can cause loss of protein, infection, pneumothorax, hemothorax, and electrolyte imbalances.