Pleurectomy/Decortication vs Extrapleural Pneumonectomy

I would say there are some instances where we still have to do an extrapleural pneumonectomy where we take out the lung. The main difference is though, and that's probably very less common, The main difference with a pleurectomy decortication versus extra pleural pneumonectomy is that the nice thing about the pleurectomy decortication is that you're just removing the lining. I feel that really a pleurotomy and decortation should always be on the patient's mind first and really should be on the surgeon's mind first. And that, yes, sometimes, every once in a while, one percent of the time or five percent of the time, we have a bailout where, hey, this long It's just so infiltrated with mesothelioma and we take off the peeling, the lining, the mesothelioma and we see the lung and every once in a while, like I said, one in the last five years, the lung is just totally not functional anymore. In that case, again, is the nuances, right? These are nuances that people don't talk to you about. That case, you do wanna remove the lung because if you do leave the lung in and it's already pretty much not a functional lung, that can actually do worse because you may have to go back in and take out, go for a second operation because that lung just was too foregone with compression of the mesothelioma. So I think that's kind of the nuance with it, but bottom line is what we should be all telling patients and advocating for is a pleurectomy and decortication.