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Lung Scarring and Mesothelioma Surgery

Lung Scarring and Mesothelioma Surgery

Mesothelioma patients with scarring on their lungs may have more complications after surgery.

Mesothelioma is a type of cancer that often affects the lungs. It is caused by exposure to asbestos. If asbestos fibers are inhaled, it can become trapped in the membrane lining the lungs. This membrane is called the pleura.

The trapped asbestos fibers can irritate the pleura. Over time, this long-term irritation causes scarring of the lungs. Doctors call this “pleural thickening”. It is possible for the scar tissue to become thick enough to impair breathing.

A common treatment for mesothelioma is surgery. A surgeon will remove as much of the mesothelioma tumors as possible. This is often followed by chemotherapy and radiation.

Receiving surgery can be hard on a patient, depending on the severity of cancer and type of surgery. The amount of pleural thickening could indicate how well a patient will recover after surgery.

A study published in Annals of Surgical Oncology looked records for 47 patients. These patients received surgery for mesothelioma between 2005 and 2021. The researchers paid attention to post-surgery complications within 90 days of surgery.

The patients in the study received one of two types of surgical procedures. Twenty-seven patients received extrapleural pneumonectomy (EPP). EPP is the most invasive surgery for mesothelioma. It involves removing diseased portions of the lung. The remaining 20 patients received pleurectomy/decortication (P/D). This procedure removes parts of the lung lining and chest lining.

The researchers found that 49% of patients experienced post-surgery complications. Six patients with EPP experienced respiratory failure. Seven patients with P/D experienced air leakage.

An analysis of these complications found that pleural thickness coincided with post-surgery complications. This was especially true when pleural thickness occurred on the right lung.

Doctors could use this information to better manage post-surgery complications in mesothelioma patients. It could improve survival rates and quality of life for mesothelioma patients receiving surgery.


Ito T, Nakamura S, Kadomatsu Y, et al. Impact of Pleural Thickness on Occurrence of Postoperative Complications in Patients with Malignant Pleural Mesothelioma [published online ahead of print, 2022 Nov 13]. Ann Surg Oncol. 2022;10.1245/s10434-022-12790-9. doi:10.1245/s10434-022-12790-9

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