The purpose of diagnostic surgeries for mesothelioma is to obtain a tissue sample of the pleura, the lining of the lung, especially if a biopsy cannot be obtained by fine-needle aspiration. Diagnostic surgeries can include one or more of the following, depending on the type of mesothelioma and how easy it can be to access the tumor(s).
- Thoracoscopy (pleural)
- Laparoscopy (peritoneal)
- Mediastinoscopy (pericardial)
- Thoracotomy (pleural, pericardial)
- Laparotomy (peritoneal)
Surgery for Pleural Mesothelioma
Several surgical options are available for those pleural mesothelioma, which is the most common form of the disease. These procedures are sometimes followed by chemotherapy or radiation to kill or prevent the growth of remaining cancer tissue.
A pleurectomy involves removal of the pleura (the lining of the lungs). The surgeon will make an incision, through which he will remove both the inner and outer lung linings. Depending on the size of the tumor and whether any metastasis has occurred, the surgeon may remove some of the lung tissue beneath the pleura.
If the mesothelioma only affects one of the lungs, a pneumonectomy may be performed to remove the entire lung. During the surgery, the diseased lung will be deflated and removed through a large incision. It is an intensive surgery that can require up to two weeks in the hospital, and several months until full recovery.
Extrapleural Pneumonectomy (Curative)
In rare cases, in addition to removing the lung, a surgeon will remove the areas surrounding it, including other mesothelial tissue, such as the lining of the heart and/or abdomen, and part or all of the diaphragm. This is an extremely difficult surgery and can result in severe complications.
This procedure is used to remove fluid from around the lungs (pleural effusion), which can make it difficult and painful for mesothelioma patients to breathe. It is usually an outpatient procedure performed by inserting a long, thin needle into the pleural space to withdraw the fluid.
If fluid buildup cannot be controlled by pleurocentesis, a surgeon may insert talc into the pleural space, which will cause inflammation and stop fluid from collecting. It can be an intensive procedure requiring several days in the hospital, and up to two months for full recovery.