Extrapleural pneumonectomy is a surgical treatment for malignant mesothelioma. It involves the removal of a lung, a portion of the diaphragm, the linings of the lungs and heart (parietal pleura and pericardium). This is a serious operation that is performed only on those patients whose cancer is confined to the chest cavity, and are deemed to be sufficiently healthy.
Because the procedure is so demanding from a technical standpoint, extrapleural pneumonectomies are usually done in larger, better-equipped medical centers. The procedure itself requires that the patient is put under general anesthesia. A large incision in the chest is made and the sixth rib may be removed in order to expose the diseased lung and open up the working space. Next, the diseased lung is collapsed and its major blood vessels and main bronchial tube are clamped; these will be stitched or stapled shut later on. The diseased lung is then removed, along with the pleural lining, pericardium and parts of the diaphragm. These are replaced with patches synthetic material. Finally, the chest incision is sutured shut, and a temporary drain is inserted into the chest cavity.
Extrapleural pneumonectomy inhibits metastasis in mesothelioma cases. Patients who undergo this operation enjoy significant increases in their mesothelioma survival rate when treated with radiation and chemotherapy in addition to the surgery.
This mesothelioma surgery is nonetheless controversial and quite dangerous. Some doctors believe that the risks outweigh the benefits. Such risks include:
- hemorrhage (internal bleeding)
- respiratory failure
- empyema (accumulation of pus in the chest cavity)
- blood clotting in the veins of the inner thigh or leg
"Extrapleural Pneumonectomy." From the International Mesothelioma Program's website.