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Decortication is a medical procedure involving the surgical removal of the surface layer, membrane, or fibrous cover of an organ.The procedure is usually performed when the lung is covered by a thick, inelastic pleural peel restricting lung expansion.
If the lung was otherwise healthy, then certain aspects of lung function, such as vital capacity, may improve after decortication. [3] If, however, the lung had significant disease, then lung function often does not improve and may even deteriorate after such intervention. [3] The duration of fibrothorax does not affect prognosis. [3]
A thoracotomy is a surgical procedure to gain access into the pleural space of the chest. [1] It is performed by surgeons (emergency physicians or paramedics under certain circumstances) to gain access to the thoracic organs, most commonly the heart, the lungs, or the esophagus, or for access to the thoracic aorta or the anterior spine (the latter may be necessary to access tumors in the spine).
Patients should, of course, be advised to return sooner if symptoms redevelop. Long-term sequelae of pleural empyema are rare but include bronchopleural fistula formation, recurrent empyema and pleural thickening, which may lead to functional lung impairment needing surgical decortication. [12]
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Pleurodesis is performed to prevent recurrence of spontaneous pneumothorax or pleural effusion, and can be done chemically or mechanically.It is generally avoided in patients with cystic fibrosis if possible, because lung transplantation becomes more difficult following this procedure.