Pleurectomy and Decortication

Overview and Facts about Pleurectomy and Decortication

Pleurectomy and decortication is a type of thoracic surgery used to help people with pleural mesothelioma, which is a type of cancer caused by asbestos exposure that damages the lining of the lungs.

• Pleurectomy: Removal of the lining surrounding the affected lung
• Decortication: Removal of any tumor masses growing inside the chest cavity

While the procedure cannot cure mesothelioma, it can help control the buildup of fluid, improve breathing and lessen cancer pain. It is often called “lung-sparing surgery” because it allows the patient to keep their lungs after the tumor is removed.

Pleurectomy and decortication is often the best surgical procedure for patients in the early stages of mesothelioma (stage 1 or 2).

What to Expect with Pleurectomy and Decortication

This procedure is a major surgery that involves opening the chest cavity and removing the pleural lining. It takes around five hours to perform and you will be placed under general anesthesia so you will not be conscious.

The surgeon makes an incision called a thoracotomy along the chest, exposing the chest cavity to gain access to the lung. Once they can see inside your chest, they’ll remove the outer lining of the lungs, also known as the parietal pleura.

Once the lining has been removed, the surgeon will move on to the decortication. Most likely you’ll have some tumors in your chest area, and the surgeon will take this opportunity to remove them. To make sure all cancer cells are gone, the surgeon may have to scrape away bits of lung tissue.

After these procedures are complete, the surgeon will close the incision so you can start healing. This procedure has been shown to relieve the patient’s breathing symptoms and prevent future pleural effusions.

What are the Side Effects of Pleurectomy and Decortication?

After the pleurectomy and decortication, you’ll have a fair amount of pain and bleeding. You may also find it difficult to breathe. You will begin breathing exercises to expand your lung capacity, but you will probably be on a respirator for a few days.

Having an air leak is also common. This is when a small pocket of air escapes the lungs and gets trapped in the chest cavity. Your doctor will insert chest tubes to help this air escape, as well as to drain any fluid that might be collecting in the area.

You should also expect to have sputum (a mixture of saliva and mucus coughed up from the respiratory tract) in your lungs. This will probably cause you to cough, which is normal. Total recovery will take another four to six weeks after discharge.

It may be difficult for you to maintain proper nutrition following surgery for pleural mesothelioma. You may experience nausea, vomiting, loss of appetite and a change in bowel habits.

A nutritional assessment should be performed pre-treatment to anticipate and plan for possible side effects.

What are the Risks of Pleurectomy and Decortication?

Generally, pleurectomy and decortication is a lower risk treatment than many other lung cancer operations. That said, you may still be at risk for the following complications:

• Blood clots (these can get stuck in the lungs or travel to the brain and cause a stroke)
• Internal bleeding
• Pneumonia or infection
• Pneumothorax, which is when air leaks from the lungs
• Respiratory or cardiac failure