A pneumonectomy may be performed when a patient has pleural mesothelioma. In this procedure, a doctor will remove a patient’s lung. In some case, part of the diaphragm will also be removed. During the procedure, it may be necessary for a surgeon to remove one or more ribs in order to reach the lung. An obvious complication is that, with only one lung remaining, a patient has reduced ability to breathe after the surgery.
A peritonectomy may be performed to treat peritoneal mesothelioma. This surgery, which involves removing the abdominal wall, often provides comfort and less frequently results in a longer survival rate. Often, a paracentesis is performed prior to this surgery to remove fluid from the abdomen. There is a high risk of infection after a peritonectomy.
One of the most radical and aggressive forms of surgery for mesothelioma is extrapleural pneumonectomy. This complicated surgery is only performed when the mesothelioma is localized, and by experienced surgeons in larger medical centers. The procedure involves removing the affected lung, the pericardium, the diaphragm and the pleural lining of the chest wall. The pericardium and diaphragm are rebuilt, using prosthetics, and placed back in the patient’s chest.
After this surgery is performed, chemotherapy and radiation are administered, in what is called a multi-modal treatment plan. Atrial fibrillation—an irregular heartbeat—is the most common complication during this surgery. Like many radical surgeries, this procedure is also high risk. There is an elevated risk of death occurring within 30 days of the surgery. In the years since this surgery was first developed, it has become both safer and more effective. When successful, this surgery may help to extend a patient’s life by several years and improve his/her quality of life. However, its effect on long-term survival is still being determined and research on this procedure is being conducted.
In rare cases, surgery may also play a diagnostic role, revealing that mesothelioma has spread to the tunica vaginalis, which covers the testis. This type of tumor is frequently discovered after a misdiagnosis of a hernia occurs, and as a procedure to correct this is performed. It is difficult to treat this tumor, and curative surgery is not typically recommended.
Depending on the type of surgery performed, the timeframe for resuming activities like eating, drinking and walking will vary. Frequently, a doctor will recommend that a patient work closely with a pulmonary therapist. Patients should also avoid smoking or exposure to smoke, and stay at a healthy weight.