Mesothelioma Surgery
Understanding the Treatments of Mesothelioma
A mesothelioma diagnosis based upon fluid is often inconclusive. Because of this, diagnostic surgery becomes a much needed step in confirming and staging mesothelioma.
Thoracoscopy allows a doctor to evaluate the pleural cavity and conduct multiple tissue biopsies under direct vision. In up to 98% of cases, a definitive diagnosis can be made. Often, chemical pleurodesis aimed at relieving the fluid accumulation in the intrapleural space can be done during the same procedure. It is also possible to understand the extent of the tumor and make a determination of surgical resectability. While less invasive than an open biopsy, it can only be done on patients where tumor has not obliterated the pleural space.
VATS, also known as video-assisted thoracic surgery is an alternative to thoracoscopy. However, because of its invasive nature, concerns of tumor seeding increase. By using small incisions, the doctor can observe the pleural space with the help of a camera and obtain enough tissue samples for a pathologist's analysis. The pleural involvement, chest wall invasion, or otherwise extent of the tumor, can also be determined, and recommendation as to the type of debulking procedure needed can be made at this point.
Mediastinoscopy can be used as an aid in staging the extent of disease when enlarged nodes are viewed using imaging techniques.
Laproscopy is used in mesothelioma patients when imaging techniques suggest possible invasion of the tumor through the diaphragm. This information can be important in evaluating a patient for extrapleural pneumonectomy or potential pleurectomy.
