Pleuropneumonectomy
Major surgery to remove a mesothelioma tumour that has not spread may be undertaken in a very few cases. The operation which attempts to remove all of the mesothelioma is known as pleuropneumonectomy. It involves very major surgery, removing the lung, its lining membranes, the pericardium which lines the heart, some of the diaphragm and sometimes ribs and chest muscle. Even after this, some mesothelioma tumour may remain and require additional treatment such as chemotherapy or radiotherapy. The operation is rarely attempted.

Palliative surgery
Surgery is also used to treat symptoms (palliative surgery):

Pleurodesis

This is used to prevent the build-up of fluid in the lungs if this is a recurring problem. Keyhole surgery is usually used, involving three small cuts to the chest to enable slender instruments to be used, guided by a tiny camera. In the operation, some sterile talc is inserted through a small tube and this sticks the layers of the pleural membrane together, to try to prevent any further fluid collecting. This may be done under local anaesthetic when fluid is drained, but it usually requires a few days of recovery in hospital. Alternatively, it may be done by the surgeon carrying out a surgical biopsy.

Pleural catheter

An alternative to pleurodesis is to have a pleural catheter (a draining tube) placed into the chest. This is left in place indefinitely, and you are taught how to attach a bottle to the catheter and drain the fluid away yourself. This reduces the need for you to attend hospital.

Peritoneal mesothelioma

If the disease is found early enough, it may be possible to cut it out. This may involve removing part of the bowel, the peritoneum (the lining of the abdomen), and possibly other organs if they are affected. However, in most cases of peritoneal mesothelioma, surgery is not possible as the tumour has already spread.

Whatever kind of surgery you are having, you will meet your surgeon face-to-face before your operation. She or he will explain what will happen during the operation and also the possible complications that can happen following it. You can find a link to a list of questions you might like to ask your surgeon by following the link given below.

Preparing for a general anaesthetic

All these operations are done whilst you are unconscious, under general anaesthetic. If such an operation is planned, your fitness for a general anaesthetic will need to be tested, usually by a nurse specialist at a pre-assessment clinic. An appointment will be arranged with you before the planned date for your surgery. You will be asked about your general health, about any breathing or chest problems you have, about any medicines or supplements you are taking, and allergies. A blood sample may be taken. Your pulse and heart-rate may be monitored. You will not be asked to do exercises.

Related links
Surgery - general