恶性胸膜间皮瘤（MPM）是一种具有侵略性、致命性极高且治疗选择有限的癌症。尽管付出了许多努力，但对治疗和预后的真正突破一直难以实现。胸腔积液并伴有明显呼吸困难和疼痛是患有MPM的个体最典型的表现。虽然胸腔穿刺能够缓解呼吸困难，但大多数这种胸腔积液会快速复发，因此通常需要进行决定性手术治疗以防止再次发生。不幸的是，对于反复发作的MPM相关积液个体而言，最佳治疗方式尚不清楚，且实践中存在相当大的差异。此外，由于MPM引起的胸腔积液常伴有不可扩张肺，这使得症状的有效减轻更加困难。本文深入探讨了针对MPM相关的胸腔积液和不可扩张肺可用的最新治疗选择（包括手术和非手术）。我们将讨论决定决定性手术治疗选择的因素，需要根据个体患者进行调整。版权所有© 2023澳大利亚和新西兰心脏和胸外科医师协会（ANZSCTS）和澳大利亚和新西兰心脏学会（CSANZ）。由Elsevier B.V.出版。保留所有权利。

Malignant pleural mesothelioma (MPM) is an aggressive, almost universally fatal cancer with limited therapeutic options. Despite efforts, a real breakthrough in treatment and outcomes has been elusive. Pleural effusion with significant breathlessness and pain is the most typical presentation of individuals with MPM. Although thoracentesis provides relief of breathlessness, most such pleural effusions recur rapidly, and a definitive procedure is often required to prevent a recurrence. Unfortunately, the optimal treatment modality for individuals with recurrent MPM-related effusion is unclear, and considerable variation exists in practice. In addition, non-expandable lung is common in pleural effusions due to MPM and makes effective palliation of symptoms more difficult. This review delves into the latest advances in the available management options (both surgical and non-surgical) for dealing with pleural effusion and non-expandable lung related to MPM. We discuss factors that determine the choice of definitive procedures that need to be tailored to the individual patient.Copyright © 2023 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.