| Thoracentesis for Pleural Mesothelioma: Who will Benefit More and Who is Most at Risk for Complications? Pleural effusions, one of the primary symptoms of pleural mesothelioma, can cause a considerable amount of discomfort and often require palliative treatment. These effusions are typically treated by a thoracentesis - a short procedure that drains excess fluid and relieves pressure on the lungs. While the procedure can help alleviate respiratory distress caused by the effusions and benefits many patients, it is not entirely free of potential complications. A 2010 study sought to identify patients who would benefit the most from the procedure and present the smallest risk of side effects. Of 446 participants, including a number of malignant mesothelioma patients, the incidence of pneumothorax, or a collapsed lung, was "significantly lower" in the patients whose procedure was guided by an ultrasound. An ultrasound allows the doctor to identify the appropriate site and more accurately perform the thoracentesis. Patients with exudative (protein-rich) pleural effusions were found to have a higher risk of post-operative complications when compared to patients with transudative (watery) effusions. Of 208 participants with exudative effusions, 13 experienced one or more complications. The remainder of the patients had transudative effusions, and only three developed side effects from the procedure. Asbestos-related diseases typically cause exudative effusions. Another factor that increased a patient's risk of complications following the procedure was the presence of symptoms from the patient's primary disease. The procedure led to complications for only one asymptomatic patient (out of 328 total), while 15 of 118 symptomatic patients developed complications. During a thoracentesis, a doctor will insert a slim tube into the pleural cavity and extract the excess fluid. The entire procedure takes approximately 15 minutes, and most potential complications emerge within a few hours after the treatment. Most patients remain at the facility where the procedure was performed for several hours to monitor any side effects. The most common complication of a thoracentesis is a collapsed lung. Additional side effects can include pain, bruising and bleeding at the insertion site. These mild complications are easily treated and are typically not a cause for major medical concern. Infection and liver injury have also been noted after thoracentesis, yet the incidence rates for these conditions are rare. Additional information on mesothelioma and other common treatment options may be found through the Mesothelioma Center. | 
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