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Mesothelioma Pleurectomy/Decortication (P/D)

Pleurectomy/decortication (P/D) is a type of surgery used to treat pleural mesothelioma, a type of cancer caused by asbestos exposure. This procedure involves the removal of the pleura, or outer lining of the lungs and chest cavity, which can help to reduce symptoms and improve prognosis.

P/D may also be used to remove tumors or other tissue that has spread to the chest wall. This procedure aims to reduce pain and improve the quality of life for patients with mesothelioma. It is important to note that this surgery does not cure mesothelioma but can help extend life expectancy in some cases.

Who is Eligible For a Pleurectomy/Decortication

Not everyone is eligible for this procedure. Candidates must be in good overall health and should not smoke to reduce the risk of complications from surgery. Smokers must quit smoking well in advance of the operation to ensure optimal results from the surgery.

Additionally, your mesothelioma must not have spread too far out of the chest cavity for you to be a candidate for a P/D.

It is important to note that, to be eligible for the procedure, you need to have good lung function. Otherwise, the surgery may have a negative effect.

Ultimately, the decision to undergo a pleurectomy/decortication will be based on your individual case and will be made after careful consideration by you and your healthcare team.

What to Expect from Your Pleurectomy/Decortication

Patients considering a P/D should understand what to expect before, during, and after surgery. This includes pre-operative preparation, such as quitting smoking and avoiding certain medications, understanding the risks of this type of surgery, and post-operative recovery time. With proper preparation and monitoring by your medical team, you can expect a successful outcome from your P/D procedure.

Before Your Pleurectomy/Decortication

You may have to stop taking certain medications before your P/D. Medications you may be advised to stop include blood thinners or nonsteroidal anti-inflammatory drugs. Your healthcare team will let you know if that is the case – do not stop taking medications unless instructed.

During Your Pleurectomy/Decortication

You will be put under general anesthesia for this surgery, and a breathing tube will be inserted to help you breathe while you’re unconscious. You’ll be positioned on your side for the operation.

During this surgery, a surgeon will make an incision in the chest wall and carefully remove diseased or damaged tissue while preserving healthy tissue as much as possible. A pleurectomy decortication does not guarantee a cure for pleural mesothelioma.

After the pleural lining and any other abnormal tissue have been removed, the chest will be closed up with sutures or staples. A chest tube will typically be inserted through the incision to help drain any fluid that may accumulate in the pleural cavity following the surgery.

The procedure usually takes several hours to complete, and you will then be moved to a recovery room, where you are closely monitored for any complications or adverse reactions.

After Your Pleurectomy/Decortication

You’ll have to stay in hospital for a number of days after the operation. You will be monitored closely during your stay for any potential complications, such as infection or bleeding. You will also be encouraged to get out of bed and move around a little each day to speed up your recovery process.

It can take up to 8 weeks for people to resume normal activities, during which time you will need to work closely with your medical team to ensure you recover fully. You may need to have pulmonary rehabilitation to ensure your lungs work as well as possible.

Risks and Side Effects of a Pleurectomy/Decortication

The risks and side effects of a pleurectomy/decortication include:

  • Anesthesia risks: As with any surgery that requires anesthesia, there is a risk of complications related to the use of anesthesia, such as allergic reactions or breathing problems.
  • Bleeding: There is a risk of bleeding during and after the surgery.
  • Infection: As with any surgery, there is a risk of developing an infection at the surgical site.
  • Lung injury: The lung can be injured during the surgery, leading to difficulty breathing or pneumonia.
  • Pain: Pain is common after the surgery and may be managed with medication.
  • Pneumothorax: There is a risk of pneumothorax (a collapsed lung) occurring during or after the surgery.
  • Recurrence of pleural effusion: Pleural effusion may recur after the surgery.

Benefits of a Pleurectomy/Decortication

Because this surgery removes the pleura, the tissue that lines the lungs, and any cancerous cells from the chest cavity, it can mean people can avoid having an entire lung removed.

Some other benefits of this procedure include the following:

  • Relief of symptoms: The procedure can help to alleviate symptoms such as shortness of breath and chest pain caused by pleural effusions (buildup of fluid in the pleural space) or pleural thickening.
  • Improved lung function: Removing the pleura can improve lung function by allowing the lungs to expand more fully.
  • Reduced risk of cancer recurrence: In some cases, a pleurectomy/decortication may be performed in conjunction with other cancer treatments as a way to reduce the risk of cancer recurrence.


Read on for the answers to some commonly asked questions about pleurectomy/decortication procedures.

What is the purpose of a pleurectomy/decortication procedure?

The goal of the procedure is to remove the diseased pleural tissue and any other abnormal tissue to allow the lung to expand more easily, which can help to improve breathing.

How long does a pleurectomy/decortication take?

The procedure typically takes several hours to complete.

What is the recovery time like after a pleurectomy/decortication?

The recovery time will vary depending on a person’s age, overall health, and the specifics of the procedure. In general, you can expect to experience some pain and discomfort following the surgery and will need to take it easy for a few weeks.

Will there be any scarring?

The chest incision made during the surgery may leave a scar.

Next Steps

It’s important to have a detailed discussion with your doctor and surgeon about the specific risks and benefits of the procedure in your case and the alternative treatments available.

It’s important to note that the benefits of a pleurectomy/decortication will depend on the patient’s specific condition and the procedure’s reason. It’s always best to consult with a medical professional for personalized advice. For help with a mesothelioma case, contact an experienced mesothelioma attorney.