Pleurectomy

In a pleurectomy, the patient’s parietal pleura is removed from the lung. When used as palliative treatment, this procedure may be done when more extensive surgery is not an option. A pleurectomy is an effective way of controlling pleural effusion in patients whose lung expansion is restricted by mesothelioma. A pleurectomy can also be performed as a possibly curative measure in patients with Stage I or Stage II mesothelioma.

During a pleurectomy, an incision is made at the back and side of the chest that is affected by the tumor. In addition, the surgeon may remove a rib to access the diseased lung. Next, the parietal pleura is stripped from the lung. Lastly, tubes are placed between the ribs to drain blood and manage any air leaks.

A pleurectomy should only be performed if the normal space between the parietal and visceral pleurae remains and the two layers of the pleura have not merged together. If the pleural layers have merged, the surgeon must also strip the underlying lung tissue known as the decortication.

Patients who receive a pleurectomy for mesothelioma survive an average of 6 to 21 months after the procedure. Approximately 9% to 40% of patients live up to two years. These statistics have a wide range because research groups use varying treatment combinations. For example, one treatment group may receive a pleurectomy along with chemotherapy while another group may not.