What Are the Differences Between a Pleurodesis & a Thoracentesis?

Lung disorders, such as mesothelioma and pleural effusions, can cause fluid to build up around the lungs. This fluid puts stress on the lungs and may even cause them to collapse. To test for these disorders and treat them, doctors commonly use two different procedures: a thoracentesis and a pleurodesis.

Diagnostics

• Thoracentesis is primarily used as a method to diagnose a problem. In the procedure, a small needle is inserted into the fluid-filled pleural area surrounding the lungs. A small amount of fluid is drawn from the area for testing. It is normal for there to be a small amount of fluid present in this area at all times. If the fluid is excessively cloudy, it can signify a problem, such as mesothelioma. If the fluid is completely clear, it can indicate other medical issues.

Treatment

• When a doctor finds a problem with an increased amount of fluid surrounding the lungs of a patient, the thoracentesis becomes a treatment option. A small needle is inserted into the pleural space, just as it is for a diagnostic test. However, instead of withdrawing a small amount of fluid for testing, a larger amount of fluid is removed to reduce the fluid in the space to a normal level of fluid. This procedure, however, is not meant to be done repeatedly.

Pleurodesis

• After the thoracentesis is done, the lungs should return to normal. However, depending on the medical condition that plagues the patient, the pleural space may fill up with too much fluid repeatedly. When this happens, a pleurodesis is performed. For this procedure, a thoracentesis is first performed to remove the excess fluid. Once the fluid is removed, the doctor then injects a medication into the pleural space. This medication irritates the area, causing it to swell and stick together, eliminating the risk of fluid build up.

Procedure Differences

• The tools needed for each procedure also vary. Thoracentesis requires a needle and catheter, which is attached to a syringe or vacuum bottle, used for draining the fluid. The pleurodesis is done through a chest tube or catheter. The anesthesia for each procedure is also different. For instance, a thoracentesis requires only local anesthesia to numb the insertion site. A pleurodesis, on the other hand, requires either conscious sedation with a local anesthetic when performed by a pulmonologist, or general anesthesia when performed by a surgeon.