Background
Pleurectomy is a type of surgery in which part of the pleura is removed. This procedure helps to prevent fluid from collecting in the affected area and is used for the treatment of mesothelioma, a pleural mesothelial cancer. [1] Pleurectomy provides symptomatic relief but does not appear to benefit survival rates.
Malignant pleural effusions generally result from metastatic spread of disease to the pleura and are commonly seen in the course of many tumors. Less frequently, effusions are associated with primary tumors of lung, pleura, or mediastinum.
Many nonsurgical methods have been proposed to control effusion and to improve respiratory function. Nonetheless, many studies have demonstrated the benefits of pleurectomy in patients with malignant effusions secondary to various cancers. [2]
Pleurectomy reduces the risk of symptomatic pleural effusions and recurrence of spontaneous pneumothorax. [3]
Indications
Pleurectomy is most commonly indicated for mesothelioma. However, other less common indications include the following:
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Primary pneumothorax
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Pneumothorax secondary to chronic obstructive pulmonary disease (COPD)
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Traumatic pneumothorax
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Malignant pleural effusions
Outcomes
Pleurectomy can be safely performed and effectively controls the symptoms of pleural effusion that develops with malignant pleural mesothelioma. The addition of postoperative phototherapy or intrapleural chemotherapy does not improve long-term survival, but pleurectomy does result in symptom palliation. [4]
