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Lung Decortication

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Abstract

The most common indications for lung decortication are empyema and fibrothorax. Occasionally, hemothorax will require decortication, although more often, only drainage is necessary. Decortication is used to liberate lung parenchyma that has become entangled in an ongoing benign pleural inflammatory process. As this process continues, the lung ultimately becomes constricted and is prevented from fully inflating to fill the thorax (Fig. 38.1). This results in pulmonary restriction on the affected side and obligates respiratory insufficiency, often a result of shunting and V/Q mismatch. Surgical therapy is aimed at removing this fibro-inflammatory peel (the cortex) that tethers and restricts both visceral and parietal pleurae, thereby liberating the lung to inflate.

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Correspondence to Sudish C. Murthy M.D., Ph.D. .

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© 2013 Springer Science+Business Media, LLC

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Murthy, S.C. (2013). Lung Decortication. In: Mandell, B. (eds) Perioperative Management of Patients with Rheumatic Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-2203-7_38

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  • DOI: https://doi.org/10.1007/978-1-4614-2203-7_38

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-2202-0

  • Online ISBN: 978-1-4614-2203-7

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