Abstract
Surgery for malignant pleural mesothelioma has an interesting history and in select patients remains vital for best outcome. Due to the nature of the pleural malignancy, at best, resection that is possible with “curative intent” is a macroscopic complete resection (MCR), which can leave microscopic residual tumor. These surgeries are extensive procedures and were fraught with very high morbidity and mortality which overshadow any potential benefit. With improvement in surgical techniques and experience, anesthetic, and critical care management, the morbidity and mortality are significantly reduced to appreciate the benefits. The maximum benefit is seen in a multimodality treatment setting in centers with the appropriate surgical expertise. The optimal surgical procedure and various multimodal protocols are in flux, but the principles that are critical include a complete MCR either by pleurectomy and decortication or extrapleural pneumonectomy with neoadjuvant or adjuvant therapy. Considering the overall survival and quality of life, pleurectomy and decortication is at present the preferred approach for MCR in majority of patients with MPM.
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Chauhan, D., Vigneswaran, W.T. (2019). History of Pleural Surgical Treatment. In: Hesdorffer, M., Bates-Pappas, G. (eds) Caring for Patients with Mesothelioma: Principles and Guidelines. Springer, Cham. https://doi.org/10.1007/978-3-319-96244-3_1
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