Pleurectomy
Pleurectomy is a surgical treatment for pleural mesothelioma that relieves pain caused by fluid in the chest cavity. It is a palliative treatment, meaning it is performed to improve the quality of someone's life rather than to cure the person's disease. By removing the lining of the lung and other nearby tissue, surgeons are able to reduce the buildup of fluid within the chest cavity, a condition experienced by up to 90 percent of all malignant pleural mesothelioma patients. This fluid buildup, called pleural effusion, can create significant chest pain and can lead to difficulty breathing. Pleurectomy helps to minimize these symptoms by creating more space for the lung to expand.
Today, pleurectomy is almost always combined with another procedure called decortication. Together, pleurectomy/decortication still removes the lining of the lung but also removes any visible tumor growth within the chest cavity. The added decortication part of the procedure turns an otherwise palliative procedure into a potentially curative one, meaning it may extend life span rather than only easing symptoms. Pleurectomy/decortication (P/D) effectively replaced pleurectomy alone. Now, pleurectomy is so rarely performed without decortication that the word "pleurectomy" almost always refers to the complete P/D procedure.
If you're not sure what treatment options are best, speak with an experienced mesothelioma specialist. The Mesothelioma Center can help you find the perfect doctor for your diagnosis. Use our Doctor Match Program to get started now.
When a Pleurectomy is Considered an Option
A surgeon may consider performing a pleurectomy in the rare case that a patient is well enough for surgery but not a good candidate for potentially curative treatment. It is used only on patients whose cancer has spread, since it does not remove any tumor growth. In these patients, removing a localized part of the tumor would be useless since tumor growth would be left in other areas.
How the Procedure is Performed
If a patient decides on pleurectomy and the thoracic surgeon approves, the patient can expect the surgery itself to be nearly identical to that of pleurectomy/decortication. The surgeon makes a long incision along the chest to gain access to the chest cavity. Then the surgeon removes the lining of the lung, as well as any surrounding tissue affected by the cancer. Unlike in P/D, cancerous growth in the area is left behind, so removing tumors from one specific area is considered ineffective.
Following surgery, patients stay in the hospital for about a week, but complete recovery takes a couple more weeks.
Complications and Success Rates
Pleurectomy is considered a safe procedure with a low mortality rate of about 1 percent. This means 1 percent of people die directly because of surgery or related complications. These rare but deadly complications include a negative reaction to anesthesia or bleeding at the incision site.
More commonly, patients experience no improvement in side effects. Since pleurectomy is a palliative procedure, doctors consider it failed if the procedure did not alleviate side effects. Researchers found the related morbidity rate to be 22 percent, meaning more than a fifth of pleurectomy patients experienced minor surgical complications or had no improvement in side effects.
Why Pleurectomy is so Rarely Performed
In the unique situation a patient may be a candidate for pleurectomy, doctors maintain that better alternatives almost always exist, such as chemotherapy and pain medication. Other palliative treatments such as pulmonary rehabilitation or acupuncture can similarly alleviate symptoms. For most patients, the palliative benefits of pleurectomy are simply outweighed by the inherent dangers associated with any invasive surgical procedure.
When Pleurectomy/Decortication is Used Instead
If a patient's mesothelioma isn't spread out, he or she may be a good candidate for P/D rather than pleurectomy. For any mesothelioma surgery, however, the patient must be in good overall health. A relatively healthy patient has a lower risk of surgical complications and a shorter expected recovery time.
In these instances, P/D is preferred over pleurectomy alone. P/D is potentially curative, so it can extend lifespan rather than strictly improving quality of life. P/D has been favored since the mid-1990s, when it was popularized by Robert Cameron, M.D. Since 1994 Cameron has been working to perfect P/D and has performed the procedure on more than 300 pleural mesothelioma patients.
Learn more about pleurectomy/decortication.Pleurectomy-related surgeries are not your only treatment options, but they are among the most common. To learn more about surgical procedures for mesothelioma, fill out the form for a free informational packet from the Mesothelioma Center.
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Last Modified Thursday, May 17th, 2012 | Disclaimer | Privacy Policy |
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