 A procedure that is designed to get two layers of the

lung lining ( the pleura) to stick together.

 This works to obliterate the space between the layers

(pleura cavity) so that fluid can no lonnger build up
between the layers.
 Before the procedure, patients are usually medicated with a

narcotic for pain and a benzodiazepine, such as Xanax, for

comfort.

 The first step of a Pleurodesis procedure, a chemical is

injected between the pleural layers via a chest tube.

 These chemicals, which provokes inflammation and

scarring.
 The scar tissue fuses the two pleural layers

together so that fluid or air can no longer build

up and collect the space.
 Mechanical pleurodesis

 Chemical pleurodesis
 causes inflammation and scarring by mechanically
rubbing the parietal (outside) pleura with gauze.

 Surgical pleurodesis may be performed with

thoracotomy and thoracoscopy

 This involves mechanically irritating the parietal pleura,

often with a rough pad. Moreover, surgical removal of
parietal pleura is an effective way of achieving stable
pleurodesis.
 Alternatively, tunneled pleural catheters (TPCs) may be
placed in an outpatient setting and often result in auto-
pleurodesis, whereby portable vacuum bottles are used
to evacuate the pleural fluid.

 Routine evacuation keeps the pleura together, resulting

in physical agitation by the catheter, which slowly
causes the pleura to scar together.
 takes an average of about 30 days to achieve
pleurodesis and is therefore the slowest means
of achieving pleurodesis among other
modalities
 Involves injecting a chemical between the pleural
membranes to create inflammation and scarring.
 Chemicals such as bleomycin, tetracycline,
povidone-iodine, or a slurry of talc can be introduced
into the pleural space through a chest drain.
 The instilled chemicals cause irritation between the
parietal and the visceral layers of the pleura which
closes off the space between them and prevents
further fluid from accumulating.
 Povidone iodine is equally effective and safe as
talc, and may be preferred because of easy
availability and low cost.

 Chemical pleurodesis is a painful procedure,

and so patients are often premedicated with a
sedative and analgesics.
 During chemical pleurodesis, talcum powder
can be inserted into the pleura
using thoracoscopy tools, or it can be mixed
with fluid into a talc slurry and inserted through
a chest tube. Once the talc is sufficiently
distributed, the doctor then removes it.
 Some patients may react badly to the procedure and
may experience chest pains, an infection, and a fever

 For a certain percentage of people, the procedure will

be ineffective and further treatment with an indwelling
catheter to drain the fluid, or a pleurectomy (removal of
the pleural) will be needed.

 Another concern, for people who may have a lung

transplant in the future, is that a previous pleurodesis
can make this procedure more difficult.
 A Pleurectomy is a surgical procedure that is done to
remove part of the pleura, the linings that surround the
lungs.
 Malignant Mesothelioma

 Recurrent Pleural Effusions

 Malignant Pleural Effusions

 Recurrent Pneumothorax
 A pleurectomy is usually done under general
anesthesia in the operating room.
 During the procedure, an incision is made along
the back and parallel to the lungs (a
thoracotomy).
 After gaining access to the chest, the surgeon
then carefully peels away and removes the
layers of pleura.
 Additional tissue may be removed if the doctor
is operating for mesothelioma.

 Before the incision is closed, drainage tubes are

placed which will be removed later on when the
bleeding and discharge is small.

 The incision is then closed, often with sutures

which will dissolve on their own.
 Difficulty in breathing

 Pneumonia

 Bleeding

 Chest infection
 Decortication is a medical procedure involving
the surgical removal of the surface layer,
membrane, or fibrous cover of an organ.

 The procedure is usually performed when the

lung is covered by a thick, inelastic pleural peel
restricting lung expansion.
 Performed under general anaesthesia.

 It is a major thoracic operation that has

traditionally used a full thoracotomy.

 All fibrous tissue is removed from the visceral

pleural peel and pus is drained from the pleural
space.
 pneumonia

 chronic empyema

 fibrothorax (formation of fibrous tissue in the

pleural space)
 infections can occur when a residual air space persists. In some
cases, the patient may need a muscle flap or an apical tent to close off
the residual space and eliminate the infection.

 bleeding can occur from the lung or the pleural surface or from lysis of
adhesions
 persistent air leakage.

 Residual air space is a frequent problem and can occur when there is
injury to the lung parenchyma.
 https://www.asbestos.com/treatment/surgery
/pleurodesis/
 https://www.verywellhealth.com/what-type-
of-procedure-is-a-pleurodesis-2249164
 https://www.verywellhealth.com/what-is-a-
pleurectomy-2249163
 http://www.melbourneheartsurgeon.com.au/d
ecortication/
 https://emedicine.medscape.com/article/197
0123-technique