Pleural Decortication

Indications

Fibrothorax (see Fibrothorax, [[Fibrothorax]])

  • General Indications for Decortication for Fibrothorax
    • Presence for >4-6 wks
    • Disabling Lung Symptoms
    • Radiologic/Clinical Evidence of Trapped Lung
      • Failure of Chest Tube Drainage to Achieve Expansion (see Chest Tube, [[Chest Tube]])

Technique

  • Definition: surgical removal of restrictive layer of fibrous material/tissue overlying the lung, chest wall, and diaphragm (which restricts lung expansion)
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Adverse Effects/Complications

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References

  • Medical and surgical treatment of parapneumonic effusions : an evidence-based guideline. Chest. 2000; 118(4):1158-71 [MEDLINE]
  • Clinical implications of unexpandable lung due to pleural disease. Am J Med Sci. 2008; 335(1):21-5 [MEDLINE]
  • Surgical treatment of chronic empyema. Gen Thorac Cardiovasc Surg. 2010; 58(7):311-6 [MEDLINE]
  • Debridement alone without decortication can achieve lung re-expansion in patients with empyema: an observational study. Interact Cardiovasc Thorac Surg. 2011 May. 12(5):724-7 [MEDLINE]