Pleurectomy-decortication is a compound operation, showing parietal pleurectomy and decortication of lung with a full resection of the visceral pleura. During the second pleurectomy-decortication of pleura is removed and the possibility that the extrapleural tissue structures, as part of the diaphragm and the pericardium, will be deleted as well. This is usually used to present patients with early stages of disease, although the individual procedures can be used for palliative purposes as well. To learn more about using this palliative, please read:
* Mesothelioma Treatment: Palliative Surgery - Debulking Pleurectomy
* Mesothelioma Treatment: Palliative Surgery - Decortication of lung
Pleurectomy-decortication is one of the two main curative surgery performed for the treatment of pleural mesothelioma. Extrapleural pneumonectomy (EPP) is another major operation.
Pleurectomy-Decortication - Overview of the Procedure
Pleurectomy-decortication (PD) is considered radical surgery because of extensive tissue resection tried during invasive procedures and techniques that are required to complete the operation. Patients who undergo pleurectomy-decortication faces a long recovery period and the serious complications that are not ordinary, but the procedure has been used to prolong survival time in a large number of mesothelioma patients.
During the initial phase of operation, extrapleural pneumonectomy pleurectomy-decortication and continue in the same way. Thoracotomy require extended posterolaterally into the chest. Conducted extensive wedge to give the surgeon a greater exposure to the patient's thorax. In some cases, the ribs 6 may be removed to facilitate entry into the pleural cavity. When the surgeon reaches this area, he will begin the actual resection.
Parietal pleura and its surroundings will be the initial target of surgery. Diaphragm likely to be removed, as if the pericardium can not be easily separated from the parietal pleura, or if it showed signs of malignancy.
The surgeon will begin what is probably the most difficult part of the operation: decortication of the lung and full resection of the visceral pleura. Some problems may affect the extent to which the two pleural effusions can be separated and clean and safe visceral removed from the lungs, so the surgeon will carefully analyze the status and structure of this network will be continued in a way that maximizes the potential for full elimination of visceral pleura and the achievement of -macroscopically complete resection. Every surgical manipulation of visceral pleura increases the likelihood of damage to the lung underlying, so the surgeon must balance the desire to achieve full resection with current status of the lung and the potential for workers lung damage.
After the surgeon has completed the operation, he must then begin the process of reconstruction needed to ensure that lung function. If the diaphragm or pericardium have been removed, the surgeon will reconstruct each structure using a fiber mesh that will achieve the same functionality as the original structure.
During the procedure, the surgeon will remove lymph nodes adjacent to post-operative performance analysis. The lymph nodes will be packaged and identified, and then sent to a pathologist for analysis. This information will inform any follow-up care that patients can undergo.
After all networks have been removed, and the diaphragm and pericardium are reconstructed if necessary, the surgeon will start the exit procedure. Unusual complication with pleurectomy-decortication, so that the surgeon will check to make sure that everything has been correctly completed and are in the appropriate country. Drainage tube will be inserted at various locations to ensure the spread of fluid from the pleural cavity and its surroundings. This should enable the expansion of the lung proper and will help the recovery of patients. Should they order, the surgeon will step back through each of the steps undertaken during the initial approach, rebuilding and reattaching tissue to be cut off at the time of entry and close the incision because he went along.
The patient will then be transferred to the Intensive Care Unit for several days before starting its monitoring of the rehabilitation program. Pleurectomy-Thoracotomy and decortication is a major operation and significant features of post-operative healing, so it is important for patients to take their recovery slowly.
Pleurectomy-Decortication - Treatment Considerations
As in all forms of radical surgery, serious complications can occur during pleurectomy-decortication, or the hours and days after that. Damage to the lungs from the manipulation of the visceral pleura is always a concern, because of complications associated with blood loss, breathing barriers and reconstruction of the diaphragm and the pericardium. However, although the possibility of complications, most surgeons feel that the candidates have to undergo curative surgery operations to maximize their potential for long-term survival. Most of the complications associated with pleurectomy-decortication is now quite popular, so even if a surgeon can not prevent them, they can plan and probably they will be ready to adjust should one arise.
Historically, pleurectomy-decortication has been shown perioperative and postoperative lower levels of mortality and morbidity than having extrapleural pneumonectomy.
Decortication vs. Pleurectomy-Extrapleural pneumonectomy
A recurring question in the treatment of mesothelioma is the extent to which pleurectomy-decortication should be selected for extrapleural pneumonectomy and what it "means" to choose one over the other procedures. Many people think that treatment is relatively interchangeable and pleurectomy-decortication is "better" choice for the treatment of pleural mesothelioma as less radical procedures that protect the lungs, while the extrapleural pneumonectomy is a "bad" option for the elimination of long and extended recovery time.
The study generally concluded that the two procedures are different domain requests and the most effective for patients in various stages of disease. Pleurectomy-decortication is generally performed in patients with mesothelioma present with only local evidence of progress that thin to the adjacent tissue, while the extrapleural pneumonectomy is most often used for patients who show a wider spread of the disease or for those who have enrolled in the treatment of EPP protocol which determines as one of the modalities in multimodal approach to the disease.
Kunci untuk semua mesothelioma operasi adalah untuk mencapai reseksi macroscopically-lengkap, sehingga prosedur yang terbaik dapat mencapai seperti reseksi pada kenyataannya "lebih baik" prosedur untuk setiap pasien. During the early stages of the disease, a pleurectomy-decortication be all that is needed to achieve complete resection, macroscopically. For patients who are fortunate enough to be diagnosed with the tumor burden is limited, pleurectomy-decortication likely to be a good choice. However, for patients who present with more extensive infiltration of tumor-norm with the majority of mesothelioma diagnosis will extrapleural pneumonectomy operations for more possible options to achieve than macroscopically complete resection is pleurectomy-decortication.
In many instances, a surgeon will not know the procedures to be performed at the beginning Thoracotomy. If preoperative imaging scan showed only a thin tissue infiltration, the surgeon may assume that pleurectomy-decortication be done, but if, after entry into the pleural cavity, it found that CT or MRI failed to disclose fully the malignancy, then surgery may be tried make extrapleural pneumonectomy. Although unlikely, the opposite may be true as well: Thoracotomy surgeon can start with the assumption of an extensive network infiltration, and therefore, the performance of an EPP, but after entry into the pleural cavity, the surgeon can see a smaller area of infiltration and the PD will be done as instead.
Pleurectomy-Decortication - Conclusion
Pleurectomy-Decortication is one of the main operations used for the treatment of pleural mesothelioma. Pleurectomy-decortication performed on patients in the early stages of mesothelioma, while a network intrusion is still relatively contained in the surface area smaller. Extrapleural pneumonectomy may have done more than pleurectomy-decortication has been done, so most of the results related to multimodal treatment EPP-based reporting of disease treatment protocols. However, pleurectomy-decortication success should continue achieving the same basic goal as a successful EPP-ie, a complete resection, macroscopically, so the use of pleurectomy-decortication in the multimodal treatment protocols may reach an average live longer than a strict protocol palliative or one that features only one modality therapy.
Related Information: Mesothelioma & Surgery
For more information related to the surgical treatment of mesothelioma, please read the following:
* Mesothelioma Treatment: Surgery
* Mesothelioma Treatment: Curative Surgery - Extrapleural pneumonectomy
* Mesothelioma Treatment: Palliative Surgery - Debulking Pleurectomy
* Mesothelioma Treatment: Palliative Surgery - Decortication of lung
* Mesothelioma Treatment: Palliative Surgery - Pleuroperitoneal pleural catheter and Shunts
* Mesothelioma Treatment: Palliative Surgery - Pleurodesis
* Mesothelioma Treatment: Surgery Technique - Thoracotomy
* Mesothelioma Treatment: Surgery Technique - Video-Assisted Thoracoscopic Surgery (vat)
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