There are two surgical approaches to mesothelioma, the pleurectomy/decortication (P/D) and extrapleural pleuropneumonectomy (PPEP). These are highly specialized surgeries, and may not be offered in all schools. All thoracic surgeons are not relevant to these types of surgeries. The ultimate goal of these procedures is to eliminate a large part of the disease, knowing that most probably the residual microscopic disease remains. Adjuvant therapy in which additional forms of treatment are used in conjunction with the primary therapy, typically seeks to eliminate residual disease. The most common forms of therapy are adjuvant radiotherapy or chemotherapy.
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. (more…)
