Decortication

Decortication is a medical procedure that involves the surgical removal of the surface layer, membrane, or fibrous cover of an organ. The procedure is often performed when the lung is covered by a thick, inelastic pleural peel restricting lung expansion. In a pulmonary context, decortication is a procedure that aims to restore lung function by removing restrictive fibrous tissue over the lung, pleura, and diaphragm.

Indications

Decortication is indicated for patients with chronic empyema and pleural effusion that does not respond to less invasive treatments. It is also used in the treatment of lung diseases and conditions that cause the lung to stick to the ribcage. This can occur in conditions such as tuberculosis, pneumonia, lung abscess, and lung cancer.

Procedure

The procedure is performed under general anesthesia. The surgeon makes an incision in the chest wall and removes the restrictive peel from the lung, pleura, and diaphragm. This allows the lung to expand and fill with air. The procedure can be performed through a thoracotomy or using a video-assisted thoracoscopic surgery (VATS) approach.

Risks and Complications

As with any surgical procedure, decortication carries risks including infection, bleeding, pneumothorax, and respiratory failure. There is also the risk of damage to surrounding organs and tissues. The patient's overall health and the extent of the disease can also affect the risk of complications.

Recovery

Recovery from decortication can take several weeks. Patients may require physical therapy to regain full lung function. Pain management and antibiotics may also be necessary.

See Also

• Thoracotomy
• Video-assisted thoracoscopic surgery
• Pleural effusion
• Empyema
• Pneumonia
• Lung abscess
• Lung cancer
• Tuberculosis