Surgery Options for Mesothelioma Patients
A pleurectomy with decortication (P/D) is one possible surgical procedure
available to mesothelioma patients. P/D procedures work by removing the
affected pleura. This releases the lungs so that they can expand and contract
normally again.
With mesothelioma patients, the pleural cavity can fill up and prevent
the lungs from expanding to their normal size, making it difficult for
meso patients to breathe normally. In healthy patients, the space between
the visceral pleura and the parietal pleura is 1mm.
Fibrothorax
Fibrothorax is a process that involves abnormal fibrous tissues inside
the pleural cavity. The presence of these fibers can cause the pulmonary
parenchyma to become entrapped, a condition commonly referred to as “trapped
lung” or restrictive pleurisy.
What is decortication?
Decortication is a surgical procedure that effectively peels away the layer
of abnormal fibers from the lung. By peeling away the layer of fibers
that are trapping the lung, the patient’s lungs are free to fill
the entire pleural space again, thus relieving the patient’s
symptoms (difficulty breathing, etc.)
How does the P/D operation work?
There are five major steps in the P/D procedure, including:
- Making an incision to expose the parietal pleura
- Separating the parietal pleura from surrounding tissue (fascia, diaphragm,
mediastinum)
- Cutting the parietal pleural open to reveal the visceral pleura
- Peeling away – “Decortation” – of the visceral pleura
- Reconstruction
For the most accurate explanation of the pleurectomy with decortation procedure,
consult with a mesothelioma physician.