The role of pleurodesis in respiratory diseases

ABSTRACT

Introduction: Pleurodesis is used to obliterate the pleural space, most commonly in patients with symptomatic malignant pleural effusions but also in patients with benign effusions or pneumothorax.

Areas covered: Traditionally, chemical pleurodesis has been undertaken at thoracoscopy or using instillation of a slurry through a chest drain. The optimum method of achieving pleurodesis, whether surgical or medical, has yet to be proven. Evidence in the different disease areas will be reviewed, along with ongoing trial evidence, which may change practice.

Expert commentary: Newer methods of achieving pleurodesis are being introduced. Studies have shown that instilling sclerosing agents via an indwelling pleural catheter or introducing drug-eluting catheters are safe and effective ways of inducing pleurodesis. There is evidence that pleurodesis might increase in survival, especially after pleural infection, possibly due to activation of the immune system. Multiple studies are currently underway to answer some of these questions and the future landscape may be very different from the present.

KEYWORDS:

• Pleurodesis
• pleural effusion
• pneumothorax
• surgery
• thoracoscopy
• indwelling pleural catheter
• talc

Declaration of interest

N Rahman has acted as a personal correspondent and received unrestricted educational grants from Rocket Medical. M Hassan reports being the recipient of a European Respiratory Society Long-term Research Fellowship. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript has not been funded.