Thoracoscopy enables a physician to assess
the pleural cavity and to behavior multiple tissue biopsies
under direct vision. In up to 98% of cases, a definitive diagnosis
can be obtained. It is also probable to gauge the extent of
the tumor, and make a determination of surgical resectability.
It can only be performed on patients where cancer has not obliterated
the pleural space.
VATS, or video-assisted thoracic surgery is
an option to thoracoscopy, although because of its more insidious
nature, concerns of tumor seeding increase. By utilizing small
incisions, the physician can view the pleural space with the
support of a camera, and obtain sufficient tissue samples for
psychotherapy by a pathologist.
Mediastinoscopy is now and then used as
an aid in production level of sickness when enlarged nodes
are seen using imaging techniques. Laproscopy is used in mesothelioma
patients in cases where imaging techniques propose possible
attack of the tumor through the diaphragm. This information
can be significant in evaluating a patient for possible pleurectomy
or extrapleural pneumonectomy.
Palliative Procedures
Palliative surgical procedures are those which treat a symptom
of mesothelioma, without aggressively treating the sickness
itself.
Chest Tube Drainage and Pleurodesis is careful
the most common of painkilling treatments. Fluid build-up,
or pleural effusion, is most often the first indication which
will on time mesothelioma patients to seek medical attention.
This is accomplished by use of a talc slurry or other sclerosing
agent which produces an adhesion.
Thoracoscopy and Pleurodesis is done in conjunction
with VATS using a crushed form of talc versus talc slurry.
Both this and chest tube drainage and pleurodesis will be
only efficient if there is no tumor encasing the lung which
restricts its growth.
Pleuroperitoneal Shunt plays a imperfect
role in palliation for quite a few reasons. Obstruction of
the catheter and possible seeding of the growth into the abdominal
crater may be concerns.
Pleurectomy, used as a palliative procedure,
may be performed where more general surgery is not an option.
It is considered the most efficient means of controlling pleural
effusion in cases where the lung's expansion is restricted
by disease.
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