Pleurocentesis Surgery for Mesothelioma Patients

Pleurocentesis, also referred to as thoracentesis, is a minimally invasive medical procedure employed to address the accumulation of excess fluid within the pleural space, the cavity located between the dual layers of the pleura encompassing the lungs. Normally, this space contains a small volume of pleural fluid, facilitating the unhindered expansion and contraction of the lungs. However, various diseases and illnesses can disrupt this equilibrium, leading to a condition known as pleural effusion, marked by the abnormal buildup of fluid.

Pleurocentesis for Mesothelioma

Malignant pleural mesothelioma (MPM), frequently attributed to asbestos exposure, can induce the excessive accumulation of fluid within the pleural space, exacerbating breathing difficulties and discomfort. Pleurocentesis serves as an effective intervention to mitigate this prevalent mesothelioma symptom, temporarily alleviating the distress associated with pleural effusion. It is noteworthy, however, that some patients may experience a recurrence of pleural effusion after the procedure.

The Pleurocentesis Procedure

Typically, pleurocentesis is a brief procedure lasting approximately 10 to 15 minutes, though its duration may extend if a substantial volume of fluid necessitates removal. The procedural steps encompass:

1. Oxygen Administration: In certain cases, patients may require supplemental oxygen during the procedure, which can be delivered through a nasal tube or face mask.
2. Needle Placement: A healthcare provider identifies the precise skin location for needle insertion.
3. Skin Cleansing: The selected skin area undergoes thorough cleansing with an antimicrobial solution.
4. Numbing Medication: A sterile numbing agent is applied to the skin, ensuring minimal discomfort throughout the procedure.
5. Needle Insertion: Once the skin is adequately numbed, a hollow needle is introduced to access the pleural space, typically causing minimal pressure.
6. Fluid Extraction: Depending on the fluid volume, a syringe or tube is employed to extract the surplus pleural fluid.
7. Catheter Placement (If Necessary): In specific instances, a flexible catheter may substitute the needle, allowing for extended fluid drainage over a day or two.
8. Needle/Tubing Removal: Once an appropriate volume of fluid has been drained, the needle and/or tube are carefully withdrawn, and the extracted fluid may be subjected to biomarker analysis.
9. Imaging and Monitoring: Additional imaging tests, such as a chest X-ray or CT scan, may be ordered to monitor potential complications arising from the procedure.

Pleurocentesis Recovery

Throughout the procedure and immediately afterward, healthcare professionals meticulously monitor the patient’s vital signs, encompassing blood pressure, heart rate, and breathing. Following medical approval, the patient can return home, with a designated individual required for transportation. Depending on the patient’s occupation, they may also need to allocate a day or two for recuperation.

The attending physician will furnish specific guidelines regarding post-pleurocentesis physical activity restrictions and will provide a list of potential severe side effects to be vigilant about, including a high fever, chest pain, or vomiting. Patients are encouraged to promptly contact their physician if any concerns arise in the weeks subsequent to the procedure.

Pleurocentesis Side Effects and Risks

Pleurocentesis is generally considered a safe procedure, with significant complications being rare. Nevertheless, some patients may encounter side effects during or following the procedure, which can encompass:

• Accumulation of air in the pleural space
• Bleeding
• Collapsed lung (pneumothorax)
• Coughing
• Fainting
• Infection
• Pain or discomfort
• Infrequent instances of cancer seeding/metastasis (dispersion of cancer cells along the incision site)
• Infrequent instances of liver or spleen injury

Specific patient characteristics and procedural factors may heighten the risk of side effects. For instance, underweight patients with a body mass index (BMI) lower than 18 kg/m2 may face an increased risk of a collapsed lung (pneumothorax). Furthermore, procedures necessitating multiple needle insertions have been associated with elevated risk. The utilization of ultrasound guidance for needle placement has been demonstrated to mitigate side effects, reduce procedural costs, and curtail hospital stays.

Benefits and Advantages of Pleurocentesis

Pleurocentesis delivers various benefits, primarily focused on symptom alleviation and enhanced quality of life. Noteworthy advantages encompass:

• The option for repeat pleurocentesis if deemed necessary.
• Mitigation of breathlessness (dyspnea) subsequent to the procedure.
• Enhanced mental and physical well-being for individuals with pleural effusion.

It is pertinent to acknowledge that approximately 30% of pleurocentesis patients may encounter recurrent pleural effusion within 15 days following treatment. In such instances, healthcare providers may recommend pleurodesis, offering more protracted management of pleural effusion.