PLEURAL MESOTHELIOMA, EXTRAPLEURAL PNEUMONECTOMY

Pleural Mesothelioma accounts for approximately seventy-five percent of all mesothelioma diagnoses in the United States. When asbestos is breathed in, the small fibers enter the deep recesses of the lung. Some asbestos fibers remain in the lung tissue where they can cause asbestosis or lung cancer. However, many asbestos fibers move from the lung to other areas of the body, including the pleura. The pleura is a very thin layer of tissue that lines the lungs. In a healthy person, the pleura facilitates the movement of the lungs as we inhale and exhale air.

Asbestos exposure causes the pleura to thicken (pleural thickening) and it also causes cancerous tumors known as pleural mesothelioma, which may arise in either the parietal or visceral pleura. The parietal pleura is the inside linings of the lungs and the visceral pleura is the outside linings. Pleural mesothelioma is difficult to contain, and often spreads throughout the pleural surface. Mesothelioma of the pleura impairs the normal functioning of the lungs and can ultimately completely disable one or both lungs. All types of mesothelioma are caused by asbestos, including the pleural variety.

Mesothelioma surgeons have performed different types of surgeries on patients with pleural mesothelioma. One of the most common types of surgery for is an Extrapleural Pneumonectomy (EPP). The EPP involves the following steps: (1) Incision and exposure of the parietal pleura: (2) Dissection of the tumor and parietal pleura from the chest wall, diaphragm, and mediastinum: (3) Division and control of the pulmonary vessels and bronchus followed by lymph node dissection: (4) En bloc resection of the lung, pleura, pericardium, and diaphragm; (5) Reconstruction of the diaphragm and pericardium. (See Argote-Greene et al., Extrapleural pneumonectomy for malignant pleural mesothelioma, Multimedia Manual of Cardiothoracic Surgery, June 28, 2005).

Another widely utilized surgical option for pleural mesothelioma is a radical pleurectomy and decortification (P/D). In this procedure, the diseased pleural tissue is removed from the surface of the lung. There is a medical debate about whether a P/D is more beneficial for patients as compared to an EPP. (See Robert B. Cameron, Extrapleural Pneumonectomy Is the Preferred Surgical Management in the Multimodality Therapy of Pleural Mesothelioma: Con Argument, Annals of Surgical Oncology, 2006). Asbestos litigation affords victims of pleural mesothelioma the opportunity to obtain financial compensation from the companies responsible for causing the exposure to asbestos. Mesothelioma lawsuits are becoming more prevalent as workers previously exposed to asbestos continue to come forward.

For more information on pleural mesothelioma and asbestos lawsuits
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