Decortication is a surgical procedure that involves the removal of the pleural lining surrounding an internal organ. Though the surgery might be recommended for the treatment of a number of organs (including the heart, brain and kidneys), decortication is most commonly performed on the lungs.

Decortication is a procedure associated with many ailments – most notably mesothelioma. Due to the fact that the surgery involves the removal of the pleural lining, decortication may be alternatively referred to as pleurectomy.

Decortication Applications

The purpose of decortication is generally to eliminate the excess fluid that has built up within the pleura (the thin wall of cells that lines an organ). Removal of this fibrous material may also be used to treat an infection, such as empyema.

In relation to mesothelioma, decortication is generally recommended for palliative purposes. This means that the surgery is not aimed at curing the illness, but rather relieving painful symptoms associated with excess buildup of pleural fluid so the patient can achieve an improved quality of life. However, in cases where the cancer is caught early and cancerous cells remain localized, decortication may be offered as a survival treatment.

In advanced stages of the illness, decortication serves as an alternative to complete tumor removal. As often is the case, the nature of growth exhibited by mesothelioma cancer makes it extremely difficult to locate and remove all cancerous cells present in the body. Due to the long latency period of mesothelioma and the vagueness of early symptoms, complete tumor removal is typically not an option.

Decortication Procedure

Decortication is a fairly invasive surgical procedure. The treatment takes place in the operating room of a hospital, with the patient placed under general anesthesia. Depending on the location of the tumor and anatomy of the patient, a rib may need to be removed to allow for access to the interior chest cavity.

Add in the fact that decortication surgeries often require the surgeon to remove cancerous tissue surrounding more than one organ, and the total time frame of the surgery can be extensive. Additionally, in cases where portions of the diaphragm or pericardium (heart lining) are removed, the surgeon is further tasked with the duty of reconstructing these organs with the use of a specialized mesh fiber.


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