Treatment of malignant pleural effusions

Abstract

Malignant pleural effusions can be treated not only by aggressive methods such as pleurectomy and talc treatment, but also in a more conservative manner, by means of drainage followed by instillation of an irritating substance. Drainage via a thoracic drain should last from 24 to 48 hours to ensure a completely empty pleural cavity and a maximal exposure of pleural surface to the irritating substance. Repeated thoracic centeses are not recommended, due to the danger of cyst formation, protein depletion, infection, and pneumothorax. Good results are obtained more or less equally with use of the various irritant products: 60-70% of patients treated show no further liquid accumulation, or require no further treatment within 30 days.