Safer Surgery for Mesothelioma Patients: Promising Strategies Revealed in Recent Study

Researchers from the University of Pennsylvania tested four strategies to make mesothelioma surgery safer for patients.

Enhancing Mesothelioma Surgery Safety

Mesothelioma is a rare type of cancer caused by asbestos. It is found in the lining of organs in the body. The most common locations for mesothelioma are in the lungs and abdomen. In this study, the patients had mesothelioma in the lungs.

The treatment plan for mesothelioma usually combines multiple therapies. The conventional treatment strategy is surgery, chemotherapy, and radiation.

One type of surgery for mesothelioma is called pleurectomy and decortication (P/D). This surgery is performed by a thoracic surgeon. The surgeon first removes as much of the diseased lung membrane as possible (pleurectomy). The second step is to scrape any remaining cancer away from the surface of the lungs (decortication).

While P/D can be effective in removing cancer from the lungs, it also comes with risks and side effects. These can include pneumonia, deep vein thrombosis, and sepsis.

The researchers in this study tested four changes to the P/D procedures that might reduce these dangerous side effects:

• creation of a tracheostomy, or tube in the throat,
• insertion of a gastrostomy tube, or tube in the stomach, two weeks before surgery,
• insertion of a jejunostomy tube, or tube in the small intestine, two weeks before surgery, and
• starting medicine to prevent blood clots.

The researchers hoped that one or more of these strategies would improve the safety of P/D for mesothelioma patients.

Study Shows How to Minimize Surgery Side Effects

To test these strategies, the researchers looked at 55 mesothelioma patients who received P/D between 2015 and 2022.

They found that patients with a tracheostomy were less likely to be infected with pneumonia. Patients who were given medicine to prevent blood clots were less likely to be affected by deep vein thrombosis. And patients with a gastronomy tube were less likely to experience sepsis.

The researchers were excited by these results and encourage more studies on larger groups of patients to gather more information about reducing side effects after P/D.

Source

Bou-Samra P, Chang A, Zhang K, et al. Strategies to reduce morbidity following pleurectomy and decortication for malignant pleural mesothelioma [published online ahead of print, 2023 Aug 13]. Thorac Cancer. 2023;10.1111/1759-7714.15067. doi:10.1111/1759-7714.15067. https://onlinelibrary.wiley.com/doi/10.1111/1759-7714.15067