Colleagues in Respiratory MedicineSurgical Perspectives on Management of Malignant Pleural EffusionsMurthy, Sudish C. MD, PhDAuthor Information Daniel and Karen Lee Endowed Chair in Thoracic Surgery; Section Head, General Thoracic Surgery; Surgical Director, Center of Major Airway Disease, Heart and Vascular Institute, Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH Disclosure: The authors declare that they have no conflicts of interest. Address correspondence to: Sudish C. Murthy, MD, PhD, Cleveland Clinic, Department of Thoracic and Cardiovascular Surgery, 9500 Euclid Avenue/Desk J4-1, Cleveland, OH 44195. E-mail: [email protected]. Clinical Pulmonary Medicine: March 2015 - Volume 22 - Issue 2 - p 74-78 doi: 10.1097/CPM.0000000000000084 Buy Metrics Abstract Malignant pleural effusion (MPE) is frequently encountered in the terminal phase of a patients’ disease. Most important at this point is swift and effective palliation of dyspnea related to the MPE. To this end, the morbidity of any intervention must be carefully considered. Interventions for symptomatic MPE include thoracentesis, percutaneous catheter placement, bedside tube thoracostomy, video-assisted thoracic surgery, and decortication. Of these, the 2 most common options for surgical management of MPE are tunneled pleural catheters and video-assisted thoracic surgery with talc poudrage. Successful palliation demands balancing patients’ wishes, performance status, and prognosis with the ability to obtain full-lung expansion and control fluid production. There is no ideal procedure; surgical treatment must be individualized. Discussions of therapy are best conducted in the setting of a multidisciplinary care team. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.