What Are the Complications of an EPP Surgery?

[MUSIC PLAYING] The complications of extrapleural pneumonectomy are numerous. Again, important to put this in perspective, we're dealing with a very bad enemy-- mesothelioma. So really, as you weigh the risks and benefits, still the operation has much more benefit than risk. But the risks are very high. The first point is that when you take out the lung, that is an unnatural situation. The chest space is empty. And the body does not feel well with an empty space because that empty space, many times, gets infected. So number one concern is infection of that space. Now, that's true for anyone who has their lung removed for cancer or otherwise. So that is one issue. And frankly, that is not a physiologic situation, so patients have to now recover from that big change in the physiology. The other issue is in that space, and I said infection is an important issue, now you're introducing foreign bodies. You can't reconstruct the pericardium with things that are absorbable, that go away, because then you have no more pericardium. So you need a physical barrier, both for the diaphragm and the pericardium. And both of those prosthetic material sitting in a tissue-- in a space that has the potential for infection increase the infection. So the number one concern for patients who are after the surgery is infection. The second concern, of course, is what happens to that space over time and how that closes. And that's where the recovery comes. The recovery is long. We're probably talking about maybe a six- to eight-week period of recovery. The last concern, which really is the first concern for the surgeon and the team, is how the patient actually is going to tolerate the changes in the physiology in the immediate post-operative period. That, frankly, goes back to planning, understanding who can have their lung removed and all of those things. And that's just part of a basic consideration of thoracic surgical concepts. [MUSIC PLAYING]