Subtotal pleurectomy by video-assisted thoracic surgery for metastatic pleuritis.

Metastatic pleuritis can be a severely disabling condition. Recurrent pleural effusion often leads to severe shortness of breath. Treatment should consist of removal of the fluid as well as prevention of the re-accumulation of the pleural effusion. We describe the technique of subtotal pleurectomy by video-assisted thoracic surgery. We show several methods of stripping of the pleura as well as the application of talc. Subtotal parietal pleurectomy provides an effective treatment and control of recurrent effusion, but due to its invasive nature, it should be offered only to patients with a reasonable life expectancy.