Left Pleural Effusion Local treatment options include repeated thoracenteses, chest tube drainage with sclerotherapy, pleuroperitoneal shunt or pleurectomy. Repeated thoracentesis is usually a temporizing measure and carries the risk for pneumothorax and pleural infection. Inpatient drainage with large-bore tubes (28–36 F) is effective, with variable 30-day success rates reported between 55% and 95%. For this reason, large-bore tube thoracostomy with sclerotherapy has become the most common palliative treatment for malignant effusions. It has to be mentioned that recent studies have shown that small drainage catheters (10 to 14 F) are as effective as large bore chest tubes in the treatment of malignant effusions. Using imaging guidance, small tubes can be placed into loculated collections, are well tolerated and have complication rates less than the larger tubes.
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