Surgery Treatment for Mesothelioma Pain

There are two surgical approaches of mesothelioma pain, the pleurectomie / decortication (P / D) and pleuropneumonectomie extrapleural (PPEP). These are highly specialized surgery, which may not be offered in all schools. All thoracic surgeons are not responsible for these types of surgeries. The ultimate objective of these procedures is the elimination of a large part of the disease, knowing that most probably the residual microscopic disease remains. Adjuvant therapy in which additional forms of treatment are used in conjunction with the primary therapy, typically aims to eliminate residual disease. The most common forms of therapy are adjuvant radiotherapy and / or chemotherapy.

The pleurectomie / decortication is considered the least radical of the two approaches since it involves only the removal of the pleura (lining of the lung) without removing the lung cover. In some cases, the pericardium and diaphragm must be removed, depending on the size of the tumor. The benefits of this procedure is a time for more rapid recovery, and utility for patients who may not be able to tolerate a more radical PPEP. The disadvantages include an increased risk of recurrence of disease because of the impossibility to remove the tumor, and the inability to use high doses of radiation adjuvants because of potential damage to the underlying lung.

The extrapleural pleuropneumonectomie is a more radical procedure which involves the removal of the lung, pleura (lining of the lung), the pericardium surrounding the heart and part of the diaphragm. During surgery, the pericardium and diaphragm are reconstructed with a material similar to Gortex. To be eligible for this surgery, patients must meet certain criteria and demonstrate stage lung function and cardiac suitable to be able to withstand the procedure.