Pleural intervention: The how, why and when - what surgeon can offer?

Diong Nguk Chai
Sultan Ismail Hospital, Johor Bahru, Johor, Malaysia

Pleural diseases that necessitate surgical intervention encompass spontaneous pneumothorax, malignant pleural effusion, and pleural infection. Primary spontaneous pneumothorax is significantly more common than its secondary counterpart. Management primarily aims to achieve lung re-expansion and prevent recurrence by bullectomy and pleurodesis via minimally invasive approach  which is video-assisted thoracoscopic surgery (VATS). Malignant pleural effusions are associated with a poor prognosis across most cancer types, and the role of surgery remains limited and highly selective. In contrast, stage II–III empyema often warrants surgical decortication, performed via thoracotomy or VATS, to eradicate infection and facilitate re-expansion of the trapped lung. This presentation includes surgical video demonstration to enhance understanding of how the procedure is performed.