Extrapleural Pneumonectomy

An extrapleural pneumonectomy is one of the most radical, aggressive surgeries performed on patients with malignant mesothelioma. During an extrapneumonectomy, the surgeon opens the chest wall at the back and side of the chest, with a cut extending towards the diaphragm. The physician will then remove the sixth rib. He or she will extract the pericardium, diaphragm, the affected lung and both layers of the pleura. Lastly, the surgeon will place grafting materials to patch the diaphragm and pericardium. Also, chest tubes will be placed between the ribs to manage air leaks from the lungs and drain any blood.

Because of the aggressiveness of an extrapneumonectomy, complications may occur. Approximately 5% to 10% of patients have died during or immediately following the surgery. In addition, approximately 25% of patients receiving this procedure experience complications such as heart attacks, breathing difficulties and vocal cord paralysis.

On average, a mesothelioma patient will survive between 4 to 21 months after the procedure. In addition, 10% to 38% of patients live up to two years. Like the pleurectomy, these statistics have a broad range because research groups may or may not choose to administer radiation or chemotherapy along with the extrapneumonectomy. In addition, patients with epithelioid mesothelioma tend to do better than those with other forms of mesothelioma. Patients interested in receiving an extrapneumonectomy should only receive surgery at a facility that has performed at least 10 of these procedures annually.