Pleurectomy Decortication

Pleurectomy/decortication (P/D) is a surgical procedure prescribed for patients diagnosed with pleural mesothelioma—a serious cancer that develops in the lungs. In the operation, the surgeon removes the membrane (or pleura) that covers the chest wall, the lungs, the membrane between the lungs (mediastinum), and the diaphragm.

The P/D operation is less extensive than other surgery options for mesothelioma patients because only the pleura is removed and not the underlying organ.This surgery attempts to remove all cancerous cells in an effort to cure early-stage cancers. It is also used to improve quality of life in patients with later-stage cancer by relieving fluid buildup and improving a patient’s ability to breathe.

Pleurectomy/Decortication (P/D): Step by Step

Patients undergoing a pleurectomy/decortication are first put under general anesthesia. The surgeon then makes a lengthy incision along the patient’s side and removes the 6th rib in order to gain access to the cancerous area of the lung. The pleurectomy is then performed, with the surgeon removing the outer lining of the chest wall along with nearby affected tissues.

This is followed by the decortication, in which the inner pleura is peeled away from the lung and any visible tumors are removed.After surgery, patients should expect to remain in the hospital for 5–7 days, or until all chest tubes have been removed and the patient is able to tolerate food.