Pleurodesis

Pleurodesis is a procedure used to prevent the repeated buildup of air or fluid in the space surrounding the lungs. By creating an intentional adhesion between the lung and chest wall, pleurodesis helps eliminate the pleural space where fluid or air can accumulate.

Tampa General Hospital’s cardiothoracic specialists use advanced pleurodesis techniques to help patients from Brooksville, Spring Hill, Crystal River and surrounding areas achieve lasting symptom relief, improve breathing and reduce the risk of future hospitalizations. Procedures are performed at TGH Brooksville, with expert consultations, evaluations and follow-up care available to patients throughout the region.

What Is Pleurodesis?

Pleurodesis, sometimes referred to as pleural adhesion therapy, is a treatment designed to eliminate the pleural space between the lung and chest wall. During the pleurodesis procedure, a medical agent or surgical technique is used to create controlled inflammation that causes the pleural layers to adhere together.

Once the pleural surfaces are fused, there is no longer a space for fluid or air to collect, helping prevent recurrent lung complications.

Pleurodesis may be performed using a chest tube, during a minimally invasive thoracic surgery or through an open surgical approach, depending on the patient's condition and overall treatment goals.

When Is Pleurodesis Recommended?

Candidates for pleurodesis are evaluated based on their symptoms, underlying condition, overall health and treatment goals. A physician may recommend pleurodesis for patients who experience recurrent pleural effusions (fluid buildup) requiring repeated drainage, have malignant pleural effusions that cause shortness of breath or have experienced multiple episodes of pneumothorax (collapsed lung) or need a long-term treatment option to reduce the risk of recurrence. For many patients, pleurodesis provides a more durable solution than repeated drainage procedures alone.

Before pleurodesis is recommended, patients typically undergo diagnostic testing to confirm the cause and extent of fluid or air buildup around the lungs. This evaluation may include chest X-rays, CT scans, ultrasound imaging, pleural fluid analysis, pulmonary function testing and laboratory studies. These tests help the multidisciplinary cardiothoracic surgery care team diagnose conditions appropriate for pleurodesis and determine whether the lung can fully re-expand after fluid or air is removed.

How Is the Pleurodesis Procedure Performed?

Several pleurodesis techniques are available, and the most appropriate approach depends on the patient's condition and specific diagnosis.

Mechanical Pleurodesis

Mechanical pleurodesis is a method of surgically abrading the pleural surfaces to cause irritation and adhesion between the surfaces.

Video-assisted thoracoscopic surgery (VATS) allows surgeons to perform mechanical pleurodesis using small incisions and specialized instruments. During VATS, surgeons can inspect the pleural cavity, drain fluid, treat air leaks and physically scrape the pleural surfaces. VATS pleurodesis is often preferred because it is minimally invasive and typically results in less postoperative discomfort, shorter hospital stays and faster recovery compared with traditional open surgery. It is often recommended for patients with recurrent pneumothorax or those at high risk for recurrence.

In certain complex cases, mechanical pleurodesis may be performed through a thoracotomy, an open procedure that involves a larger incision in the chest wall. Thoracotomy may be recommended when extensive surgical access is needed to address underlying lung disease or other thoracic conditions. Although recovery may be longer than with minimally invasive approaches, thoracotomy can provide effective treatment for selected patients.

Chemical Pleurodesis

Chemical pleurodesis is one of the most common methods. During this procedure, a sclerosing agent—most commonly sterile talc—is introduced into the pleural space through a chest tube or during thoracoscopic surgery. The agent causes inflammation that promotes adhesion between the pleural layers.

While other agents such as the antibiotic doxycycline may be used in the procedure, talc pleurodesis has demonstrated high success rates and is widely used for both malignant pleural effusions and pneumothorax prevention.

What Is Recovery Like After the Pleurodesis Procedure?

Pleurodesis recovery time varies depending on the technique used and the patient's overall health.

Most patients remain in the hospital for monitoring while chest tubes continue draining fluid and helping the lung remain expanded. Pain management, breathing exercises and early mobilization play important roles in recovery. During this time, patients may experience:

• Temporary chest discomfort
• Mild fever
• Fatigue
• Soreness at incision or chest tube sites

Many individuals return to normal activities within several weeks, although recovery timelines vary based on the procedure performed and any underlying medical conditions.

What Are the Risks and Potential Complications of Pleurodesis?

As with any medical procedure, pleurodesis carries potential risks. Patients may experience complications such as pain or discomfort, fever, infection, bleeding, incomplete pleural adhesion and recurrence of fluid or air accumulation. Though rare, certain respiratory complications could also arise.

The cardiothoracic surgery care team carefully monitors patients before, during and after treatment to minimize risks and support optimal outcomes.

Request a Consultation

At Tampa General Hospital, patients undergoing pleurodesis benefit from a multidisciplinary team of cardiothoracic surgeons, pulmonologists, oncologists, radiologists and rehabilitation specialists who work together to develop personalized treatment plans that address each patient's condition, symptoms and long-term health goals.

TGH is Florida’s premier academic health system and is affiliated with USF Health. We provide access to advanced cardiothoracic surgery expertise, minimally invasive treatment options and innovative approaches to managing complex pleural conditions. Our team is committed to providing coordinated care, ongoing support and exceptional outcomes for patients throughout Brooksville, Spring Hill, Crystal River and surrounding communities.