Analyzing Empyema After Mesothelioma Surgery

There are a few possible complications from surgery for mesothelioma. One of them, empyema, can affect survival and quality of life for patients.

A report in the Annals of Thoracic Surgery investigated the rate of empyema after pleurectomy/decortication surgery. Dr. Raphael Bueno, a lead thoracic surgeon at Brigham and Women’s Hospital in Boston, co-authored the report.

Pleurectomy/decortication (P/D) is one of two aggressive surgeries for pleural mesothelioma. It removes the pleural lining, diaphragm and pericardial lining. The other surgery, extrapleural pneumonectomy, goes a step further by removing a lung.

Patients should understand the reasons for getting either surgery and risks of any operation. First, let’s explain empyema.

 

What Is Empyema?

Empyema is the medical term for a collection of pus. It forms in the pleural space between the lungs and chest wall.

Empyema usually forms in pockets around an untreated bacterial infection. The pleural lining is removed during pleurectomy/decortication, but the procedure can cause a bacterial infection in the empty space.

Antibiotics control the infection, and a chest tube drains the pus.

 

Impact of Empyema After P/D Surgery

The study analyzed 355 cases of pleurectomy/decortication at a high-volume mesothelioma cancer center. These cases occurred through nine years.

Neoadjuvant chemotherapy was given to 87 patients, and 282 people received hyperthermic intrathoracic chemotherapy (HITHOC).

Twenty four (6.8%) patients developed empyema, and their hospital stay was significantly longer. Postoperative empyema was linked to male patients, prolonged air leaks during surgery and prosthetic mesh.

The overall survival was also nearly cut in half due to empyema:

• 11.7 months median survival with postoperative empyema
• 21.3 months median survival without postoperative empyema

 

Why to Have Surgery for Mesothelioma

While the complications from surgery might be scary, you should consider having surgery if you’re eligible. The survival benefit is often massive — usually a multi-year difference — and the chances of serious complications are low.

For instance, only 6.8% of the patients in the study developed empyema. Other serious complications — respiratory failure, kidney failure, cardiac arrest, and internal bleeding — have low incidence rates. Pneumonia, blood clots and air leakage from the lungs are the most likely complications from mesothelioma surgery. They’re all treatable or temporary.

For help finding a cancer center for surgery, contact nurse Karen Ritter. She’s a mesothelioma patient advocate and can help you schedule a meeting with a top thoracic surgeon. Email karen@mesotheliomaguide.com for help.