Clinical Pearls in Anaesthesia for Pleurectomy/Decortication for Malignant Mesothelioma

Shagun Bhatia Shah*, Itee Chowdhury, Laleng Mawia Darlong, Priyanka Goyal, Anamica Kansal
* Rajiv Gandhi Cancer Institute and Research Centre, Department of Anesthesiology, New Delhi, India

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© 2017 Shah et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Rajiv Gandhi Cancer Institute and Research Centre, Department of Anesthesiology, New Delhi, India, Tel: 9891769779; E-mails:,



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.


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.


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.

Keywords: Anaesthesia, Double lumen tube, Pleurectomy / Decortication, Malignant mesothelioma.