Thoracentesis

Thoracentesis is a surgery common for mesothelioma patients, used as a diagnostic tool and as a palliative treatment option.

Key Points

  • 1

    As a diagnostic tool, this surgery removes some pleural fluid for analysis.

  • 2

    As a palliative treatment, thoracentesis can improve breathing and reduce pain.

  • 3

    This surgical procedure is usually safe, but does have potential risks.

  • 4

    Thoracentesis can improve quality of life, but will not improve life expectancy.

Thoracentesis is a common surgical procedure used for patients with pleural mesothelioma. Also referred to as pleurocentesis, this surgery focuses on the pleural space – the cavity between the two layers of the pleura (thin layers protecting the lungs). Pleurocentesis removes air or fluid from this area, either for testing or to reduce symptoms for malignant mesothelioma patients.

Thoracentesis and Mesothelioma

A thoracentesis procedure can be done in a doctor’s office, medical center or hospital by trained physicians and usually takes less than half an hour.

The Thoracentesis Procedure
  1. A numbing anesthetic is injected into the chest wall where a hollow needle is inserted into the pleural cavity for air or fluid extraction.
  2. The needled is guided into the space using an imaging technique, such as an ultrasound, CT scan or real-time X-ray to ensure accurate placement.
  3. Patients may feel a small amount of pressure as the needle is put into place, the location is confirmed and extraction begins.
  4. Once the needle is removed, the injection area is covered with a bandage.
  5. Patients usually have a chest X-ray afterward to verify the amount of fluid that was removed and check for any complications, such as air accumulation in the chest cavity.

A pleurocentesis is usually very safe, offering more benefit than risk, but it’s important for patients to discuss with their specialist as each case is unique. In general, some potential risks include the following:

  • Complete or partial collapse of the lung, which can occur if the lung is accidentally punctured by the needle during treatment.
  • Excess fluid in the lungs (pulmonary edema), which occurs most commonly if too much fluid is removed from the pleural space.
  • Rarely, damage to the liver or spleen if the needle isn’t properly placed.

Thoracentesis and Diagnosing Mesothelioma

Normally, there is a small amount of fluid that fills the pleural space. However, when there is a fluid buildup around the lungs, it’s referred to as pleural effusion, a very common symptom of malignant mesothelioma.

When pleural effusion is detected, physicians may use thoracentesis as a diagnostic tool, extracting a sample of the fluid for analysis. Through pathology, doctors will try to pinpoint the cause of pleural buildup, as it could be an array of conditions, including mesothelioma, lung infection, congestive heart failure or kidney/liver disease. Although this procedure cannot definitively diagnose mesothelioma, it can help specialists determine symptomatic treatment and guide them towards an accurate diagnosis.

Palliative Thoracentesis for Mesothelioma Patients

Malignant pleural mesothelioma patients often face shortness of breath (dyspnea) and trouble breathing as a result of pleural effusion. The buildup of fluid can also cause coughing and chest pain. In addition to its role as a diagnostic tool, physicians also use thoracentesis as a palliative treatment option, to help ease these symptoms and make patients more comfortable throughout treatment. Benefits include:

  • Reduced chest and lung pressure
  • Increased space for lung expansion
  • Improved breathing
  • Lessened pain

When considering whether or not to undergo a thoracentesis procedure, patients should discuss with their mesothelioma specialist to understand the potential benefits and risks of the surgery. Used palliatively, pleurocentesis can offer a great amount of comfort to patients battling mesothelioma symptoms.