Pneumonectomy

A pneumonectomy is a surgical procedure to remove all or part of a lung, usually as a treatment for cancer. Because a pneumonectomy will remove much of the patient's breathing capacity, doctors choose less extreme options when possible. When exploring the possibility of a pneumonectomy, the doctor will order extensive testing of the lungs to assure that the remaining lung will have enough capacity to take over breathing for the entire body (1).

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The procedure has two varieties: a traditional pneumonectomy and an extrapleural pneumonectomy. A traditional pneumonectomy involves the removal of just the affected lung, while an extrapleural pneumonectomy removes the diseased lung along with a portion of the membrane covering the heart (pericardium), part of the diaphragm, and the membrane lining the chest cavity (parietal pleura) on the same side of the chest. An extrapleural pneumonectomy is sometimes the best treatment option for individuals with malignant pleural mesothelioma (1).

An extrapleural pneumonectomy can slow the advancement of mesothelioma and improve overall quality of life in some patients, allowing better breathing and mobility (2). Various studies have shown a significant increase in survival rates among mesothelioma patients treated with a combination of extrapleural pneumonectomy, radiotherapy, and chemotherapy. Moreover, of all treatments for mesothelioma, extrapleural pneumonectomy has the highest instance of long-term, disease-free survival (2, 3).

Because of the complicated nature of the procedure, extrapleural pneumonectomies are usually done in larger medical centers with experience with this procedure (2). The procedure itself is a major operation requiring general anesthesia. It begins with a large incision in the chest, sometimes followed by the removal of the ribs to help expose the diseased lung and make enough space in which the surgeon can work. Next, the surgeon collapses the diseased lung, ties off its major blood vessels, and clamps the main bronchial tube, which is to be stitched or stapled shut later. The diseased lung is then cut away. Next, the lining of the chest wall is removed, and parts of the heart lining and diaphragm are cut away on the diseased side, to be replaced by patches of Gore-Tex synthetic material. The chest incision is closed with sutures, and a temporary drain in the chest cavity is inserted into the chest cavity. Patients are hospitalized between one to two weeks, and are given an epidural to control pain (3).

Mesothelioma & Asbestos Cancer Glossary of Medical Terms

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Our goal is to be the best online resource for matters related to mesothelioma, asbestos cancer and other asbestos-related diseases. This article has been reviewed by certified oncologist
Michael T. Milano, M.D., Ph.D.

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