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Clinical Pearls in Anaesthesia for Pleurectomy/Decortication for Malignant Mesothelioma
Itee Chowdhury
Laleng Mawia Darlong
Priyanka Goyal
Anamica Kansal
Authors Info & Affiliations
Abstract
Background:
For most thoracic surgeries (lung resection, esophagectomy) the main purpose of inserting a double lumen tube for lung isolation is providing space for dissection and preventing lung motion by not ventilating (collapsing) the lung undergoing surgery.
Objective:
In addition, during pleurectomy/ decortication surgeries, the anaesthetist can indirectly perform the dissection of pleura from the lung without scrubbing, gloving or holding the scalpel.
Conclusion:
This is accomplished by ventilating the lung undergoing surgery, with large tidal volumes while the surgeon provides static traction to the visceral pleura. These phases alternate with one lung ventilation. A detailed account of anaesthesia for pleurectomy/ decortication follows.
