Extrapleural pneumonectomy (EPP) is a radical surgical procedure involving the removal of an entire lung along with surrounding structures, including the pleura (lining of the chest cavity), the diaphragm, and part of the pericardium (the membrane surrounding the heart). This surgery is most commonly performed to treat malignant pleural mesothelioma, a rare but aggressive cancer linked to asbestos exposure that affects the lining of the lungs. EPP is usually considered when the cancer has not spread beyond the chest cavity and offers a potential cure by removing all visible tumor tissue. The procedure is highly invasive and complex. It begins with an incision in the chest, followed by the removal of the affected lung, part of the diaphragm, and the pleura. The surgeon also removes the pericardium, which is then reconstructed along with the diaphragm using synthetic materials. The goal is to completely eliminate cancerous tissues and prevent recurrence, often in conjunction with other treatments such as chemotherapy or radiation therapy. Complications of extrapleural pneumonectomy can be significant, given the major structures involved. Risks include infection, bleeding, respiratory failure, and cardiac complications due to the proximity of the surgery to the heart. Patients may also experience prolonged recovery times, with shortness of breath and reduced physical capacity following the removal of a lung. There is also a risk of cancer recurrence, despite aggressive treatment. However, for certain patients with localized mesothelioma, EPP offers a chance for extended survival and improved quality of life.
