Pleurectomy and decortication serves as a major component of therapy for malignant pleural mesothelioma (MPM), but the procedure is time consuming. We tentatively applied a carbon dioxide (CO) blower into pleurectomy and decortication for a patient with local relapse of MPM. The blower can help increase the potential subpleural place thanks to the positive pressure by CO, while the mist of saline could clean the potential bleeding to increase visibility. Thereby, the procedure was greatly facilitated in a more precise manner, with blood loss of 100 mL and acceptable postoperative air leak and thorax drainage. Therefore, a CO blower may be considered in pleurectomy and decortication for MPM.
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http://dx.doi.org/10.1016/j.athoracsur.2021.09.046 | DOI Listing |
Ann Surg
January 2025
The Thoracic Surgery Oncology laboratory and the International Mesothelioma Program (www.impmeso.org), Division of Thoracic Surgery and the Lung Center, Brigham, and Women's Hospital, and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Objective: We hypothesize that recurrence following pleurectomy decortication (PD) is primarily local. We explored factors associated with tumor recurrence patterns, disease-free interval (DFI), and post-recurrence survival (PRS).
Summary Background Data: Tumor recurrence is a major barrier for long-term survival after pleural mesothelioma (PM) surgery.
Ann Thorac Surg Short Rep
December 2024
Thoracic Surgery Department, Nottingham University Hospitals NHS Trust, UK.
Gorham-Scout disease (GSD) is a rare skeletal disorder of unknown etiology characterized by progressive osteolysis and excessive lymphovascular proliferation. Chylothorax is a life-threatening complication. A teenager presented with a left pleural effusion on a background of chronic flank collection secondary to lymphovascular malformation.
View Article and Find Full Text PDFAnn Thorac Surg Short Rep
December 2024
Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan.
Background: In malignant pleural mesothelioma), it is difficult to evaluate the degree of tumor progression using imaging findings. It is essential to develop an objective index that is independent of imaging findings and useful for assessing the degree of tumor progression and indications for surgery.
Methods: We retrospectively evaluated the data of 79 patients with malignant pleural mesothelioma who underwent extrapleural pneumonectomy or pleurectomy/decortication at our institution between 1999 and 2022.
J Thorac Oncol
January 2025
Department of Cardiothoracic Surgery, New York University Langone Health, New York, New York. Electronic address:
Introduction: The phase 3 randomized controlled trial of extended pleurectomy decortication and chemotherapy versus chemotherapy alone for pleural mesothelioma (PM) (MARS2) reported "extended pleurectomy decortication was associated with worse survival to 2 years, and more serious adverse events for individuals with resectable PM, compared with chemotherapy alone." These results have led to considerable discourse regarding the future role of surgery for PM, and there has not been unanimity in the mesothelioma surgical community regarding the trial interpretation. This "perspective" evaluates MARS2 using internationally renowned PM experts who either agreed with the trial interpretation or who found issues with its conduct which may have influenced the results.
View Article and Find Full Text PDFInterdiscip Cardiovasc Thorac Surg
December 2024
Second Department of Surgery, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
Objectives: The MARS2 trial questioned the efficacy of curative intent surgery for pleural mesothelioma, while real-world clinical data from Japan suggest a favourable prognosis in surgical cases, indicating survival benefits in selected patients. The newly revised 9th edition of the tumour-node-metastasis classification introduces a novel indicator based on pleural thickness.
Methods: We conducted a retrospective evaluation of patients with pleural mesothelioma who underwent pleurectomy decortication between 2012 and 2022.
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