There are two surgical methods for mesothelioma, pleurectomy / decortication (P / D) and extrapleural pneumonectomy (NEP). These are highly specialized surgery and may not offer all the facilities.

Not all thoracic surgeons are experienced in these types of surgeries. The ultimate goal of these procedures is to remove as much mesothelioma, in the certainty that they will be Microscopic traces of the disease.

Adjuvant therapy, which uses additional forms of treatment with primary therapy, usually has the goal of eliminating residual disease. The most common forms of adjuvant treatment is chemotherapy and radiotherapy.

Pleurectomy / decortication is considered the least radical of the two methods since it involves only the removal of the pleura (lining of the lung) without underlying lung resections. In some cases, removed the pericardium and diaphragm, depending on the extent of the tumor.

The advantages of this procedure are usually a shorter recovery time and usefulness in patients who may not tolerate the NEP. Disadvantages include a higher risk of disease recurrence by the inability to remove all the cancerous tumor and the inability to use the high-dose adjuvant radiation at the possible risk to the underlying lung.

Extrapleural pneumonectomy is a radical procedure that involves removing the lung, the pleura (the lining of the lung), the pericardium surrounding the heart and part of the diaphragm.

During surgery, the pericardium and diaphragm are reconstructed with Gortex-like material. Patients may be candidates for this surgery only if they meet certain criteria of stages of cancer development and show the right lung and heart function to tolerate the procedure.

The pleurectomy / decortication is considered the least radical of the two approaches since it only involves the removal of the pleura (lining of the lung) without removing the lung beneath. In some cases, the pericardium and diaphragm must be removed, depending on the size of the tumor. The advantages of this procedure is a recovery time usually faster, and utility for patients who may not be able to tolerate more radical PPEP. The disadvantages include an increased risk of disease recurrence due to the inability to remove the whole tumor and the inability to use high doses of adjuvant radiation because of potential damage to the underlying lung.

The extrapleural pleuropneumonectomy is a more radical procedure that involves removing the lung, pleura (lining of the lung), the pericardium surrounding the heart and part of the diaphragm. During surgery, the pericardium and diaphragm were reconstructed with a material similar to Gortex. To be eligible for this surgery, patients must meet certain criteria and demonstrate stage pulmonary and cardiac functions appropriate to be able to withstand the procedure.