Pleurectomy, with decortication (P/D) when required, provides both a tissue diagnosis and effective control of pleural fluid accumulation and therefore excellent palliation in patients with pleural mesothelioma. We advocate early thoracotomy (VATS – video assisted thoracic surgery) in these patients.
Although the existing evidence is limited and of low quality, it suggests that P/D patients have better QoL (quality of life) than EPP (extrapleural pneumonectomy) patients following surgery. QoL outcomes should be factored into the choice of surgical procedure for MPM patients, and the possible effects on lung function and QoL should be discussed with patients when presenting surgical treatment options.
Decortication and pleurectomy via a posterolateral thoracotomy significantly improves pulmonary function and chest wall diameters in patients with chronic empyema due to tuberculosis or other diseases
SURGICAL PROCEDURES
- ICU Stay: 1 day
- HOSPITAL Stay: 4 -5 days
- TOTAL Stay in TURKEY (range in DAYS*; unless any other complications!): 13 – 14 Days
GENERAL INFO
Before Surgery
- Consultations – (Preop – *(Only Anesthesia and Chest Diseases are preoperatively included in the total charges!): Anesthesia and Chest Disease (if needed)*
- Blood Tests: Yes (Hemogram, Serology, Biochemistry, Blood type)
- Chest X-Ray: Yes
- Abdominal X-Ray: Yes
- PFT (Pulmonary Function Test): If needed! Yes – (* Not included in the total charges)!
- V/Q Scan (Lung Ventilation / Perfusion Scan): No
- Chest and/or Abdominal CT Scan – *(If the patient have the CT scans already done, then no need to take additional CT scans preop): Yes – Preop evaluation (* Not included in the total charges)!
- PET / CT Scan (Positron Emisson Tomography): Yes for MESOTHELIOMA Preop evaluation (* Not included in the total charges)!
- MRI (Chest, Abdomen and/or Brain) – *(If the patient have the MRI already done, then no need to take additional MRI preop): Yes for MESOTHELIOMA Preop evaluation (* Not included in the total charges)!
- Bone Scan: If needed! Yes – (* Not included in the total charges)!
- USG / Ultrasonography (Chest, Abdomen, and/or others: Not routine – If needed!* – Preop evaluation (* Not included in the total charges)
During Surgery
- General Anesthesia: Yes
- Local/Regional Anesthesia: No
- Local Anesthesia + Sedation: No
- Spinal / Epidural Anesthesia: Not routine!; *If needed! *(Not included in the total charges!)
- PCA (Patient Controlled Analgesia; Epidural or IV route! – *(NOT included in the total charges!): Yes
After Surgery
- HOSPITAL STAY after the ICU period, if ever: 4 -5 Days
- STAY AT HOTEL after being discharged from Hospital – *’Wound Dressing’ Everyday till the Control Day!: 8-9 Days
- First CONTROL Day! – *Get the Stitches removed, If ever!: 9th Day after being discharged to HOTEL!
- Discharged to HOME – *Take your prescription – DO NOT FORGET! – Patient generally could have “a safe flight to home” after the FIRST CONTROL!: 9th Day after discharged to HOTEL
- After – Surgery ( 3rd to 4th Weeks) – Needs CONSULTATIONS by “Medical AND Radiation Oncology Clinics”: Yes for MESOTHELIOMA Patients!
- Late – CONTROLS (1st -3rd – 6th – 12th -24th months in concordance with “the Medical & Radiation Oncology Departments Followups”)!: Yes for MESOTHELIOMA Patients!