Changes in lung function after surgery for mesothelioma

Asian Cardiovasc Thorac Ann. 2013 Feb;21(1):48-55. doi: 10.1177/0218492312454017.


Background: The effect of pleurectomy/decortication or extrapleural pleuropneumonectomy on pulmonary function has not yet been evaluated. The aim of this study was to determine the parameters of pulmonary function before and after pleurectomy/decortication or extrapleural pleuropneumonectomy.

Methods: We conducted a review of 48 patients with unilateral malignant pleural mesothelioma who underwent pleurectomy/decortication or extrapleural pleuropneumonectomy. Data including medical history, histology, survival, and pre- and postoperative pulmonary function were extracted from the medical database of the University Medical Center Freiburg, or sought by telephone interview with the general practitioner or patients.

Results: 25 patients underwent extrapleural pleuropneumonectomy and 23 had pleurectomy/decortication. Pulmonary function was not significantly reduced in the pleurectomy/decortication group postoperatively. In the extrapleural pleuropneumonectomy group, the median preoperative total lung capacity of 4.8 L (77.7%) differed significantly from the postoperative total lung capacity of 3.5 L (55.3%; p <0.0006). The median vital capacity was significantly reduced from 2.8 L (77.7%) preoperatively to 1.8 L (47.6%) postoperatively (p <0.0002). Other parameters were also highly significantly reduced after extrapleural pleuropneumonectomy.

Conclusions: Pleurectomy/decortication preserved good pulmonary function, whereas extrapleural pleuropneumonectomy significantly reduced pulmonary function, which may lead to dyspnea and influence the quality of life of these patients.

MeSH terms

  • Aged
  • Dyspnea / etiology
  • Dyspnea / physiopathology
  • Female
  • Forced Expiratory Volume
  • Germany
  • Humans
  • Kaplan-Meier Estimate
  • Lung / physiopathology
  • Lung / surgery*
  • Male
  • Mesothelioma / mortality
  • Mesothelioma / physiopathology
  • Mesothelioma / surgery*
  • Middle Aged
  • Multivariate Analysis
  • Pleura / surgery*
  • Pleural Neoplasms / mortality
  • Pleural Neoplasms / physiopathology
  • Pleural Neoplasms / surgery*
  • Pneumonectomy* / adverse effects
  • Pneumonectomy* / mortality
  • Proportional Hazards Models
  • Quality of Life
  • Retrospective Studies
  • Time Factors
  • Total Lung Capacity
  • Treatment Outcome
  • Vital Capacity