Extrapleural Pneumonectomy
Another new mesothelioma treatment is of surgical method that includes lung removal is the penumonectomy or also called pneumectomy. This procedure was first done in 1985 in order to remove the tissues in the lungs. A type of pneumectomy that has been widely used to treat malignant pleural mesothelioma for the last thirty years is the extrapleural pneumonectomy.
While cancer in the lungs has an effect on the lung tissues, malignant pleural mesothelioma is affected in the pleura, a serous membrane that separates the lungs from other body organs in the abdominal area and the chest. Though mesothelioma is not really a lung cancer, it potentially spreads to the lungs once the cancer in the pleura has metastasized. That is the reason why a standard pneumonectomy needs to be performed to remove the cancerous lung. An extrapleural pneumonectomy, on the other hand, is needed for removing the cancerous pleural tissue and the lung nearest to the affected part. The removal of the lung in extrapleural pneumonectomy is done in order to prevent the malignant mesothelioma from spreading.
There is no perfect treatment modality that can cure malignant pleural mesothelioma. The best way for the patient to survive is to use a trimodality treatment where chemotherapy and radiation therapy are performed along with extrapleural pneumonectomy.
The Candidates for Extrapleural Pneumonectomy
Extrapelural pneumonectomy surgery can be given for only few selected patients. Patients who are currently in the early stage of the malignant pleural mesothelioma with respectable cancer formation are the most likely candidates that can undergo extrapleural pneumonectomy surgery.
The most well-known cancer cell subtypes that are linked with malignant mesothelioma are epithelial cancer cells, compared to the other serious subtypes such as desmoplastic and sarcomatous. Moreover, the operative centers want to use extrapleural pneumonectomy procedures that patients with epithelioid cancer contain due to the low post-extrapleural pneumonectomy survival time of the other two.
The Procedure for Extrapleural Pneumonectomy
Because of many preoperative and postoperative treatments, extrapleural pneumonectomy surgeries become very persistent. In order to limit the preoperative pain and discomfort, patients are given general anesthesia. Also, postoperative pain is managed by inserting a thoracic epidural catheter before the operation starts.
The extrapleural penumonectomy surgery starts as it enters the chest and passes by the unobstructed sixth rib where the sixth rib is taken out occasionally. The process of extrapleural dissection begins which the surgeon provides intensive care in order to avoid entering the pleural cavity. Entrance to the pleural cavity may only lead to spillage or malignant cells within the active field. The removal of the pleura or the lining of the lung, the lining of the heart or pericardium, the diaphragm or muscles that aids in breathing, and the appropriate lung depends where the affected part of the chest is located.
Postoperative Care for Extrapleural Pneumonectomy
People’s recovery standard pneumonectomy procedure is similar to the recovery experienced by postoperative care of extrapleural pneumonecotomy patients. Postoperative patients are in danger of developing low blood pressure or hypertension which results from reconstructing the pericardium. Once a patient of postoperative extrapleural pneumonectomy experiences hypotension, follow-up has to be done immediately.
The most vital postoperative concern is managing the patient’s pain. Pain has to be controlled in order for it to lead to the breakdown of the residual lung. This is called the postoperative atelectasis. Pulmonary rehabilitation is used to restore the function of the heart to its normal state. This usually takes place on the second day, preceding extrapleural pneumonectomy.
Moreover, trimondality therapy is the best and most efficient method in order for the first stage malignant pleural mesothelioma victims to survive. Once the therapy is successful, five years to survive is possible for the patients in comparison to the one year span for survival that is common with malignant mesothelioma.
