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Pneumothorax-II01:27

Pneumothorax-II

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Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
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Pleura of the Lungs01:13

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The lungs are nestled in a cavity, shielded by the pleura. The pleura, a form of serous membrane, wraps around each lung. This membrane arrangement consists of two layers: the visceral and parietal pleurae. The visceral pleura lines the surface of the lungIn contrast, the parietal pleura is the outer layer and contacts to the thoracic wall, the mediastinum, and the diaphragm. The hilum is the point of connection between the visceral and parietal layers. The space between the parietal and...
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Pleural Disorders: Types and Brief Description01:30

Pleural Disorders: Types and Brief Description

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The pleura is a vital part of the respiratory system. It's a double-layered membrane surrounding the lungs and lining the chest cavity. The two layers of the pleura are:
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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Endoscopic Studies I: Bronchoscopy and Thoracoscopy01:30

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Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
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Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

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Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
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Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
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Related Experiment Video

Updated: Feb 26, 2026

Prone Lateral Minimally Invasive Retropleural Corpectomy Using a Rotatable Radiolucent Jackson Table
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Prone Lateral Minimally Invasive Retropleural Corpectomy Using a Rotatable Radiolucent Jackson Table

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Extrapleural pneumonectomy (EPP) vs. pleurectomy decortication (P/D).

Hasan Fevzi Batirel1

  • 1Department of Thoracic Surgery, Marmara University Faculty of Medicine, Istanbul, Turkey.

Annals of Translational Medicine
|July 15, 2017
PubMed
Summary
This summary is machine-generated.

Surgical treatments for malignant pleural mesothelioma (MPM) include extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D). P/D is recommended due to lower mortality and morbidity compared to EPP for MPM treatment.

Keywords:
Extrapleural pneumonectomy (EPP)malignant pleural mesothelioma (MPM)pleurectomy/decortication (P/D)

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Malignant Pleural Mesothelioma

Background:

  • Surgical techniques for malignant pleural mesothelioma (MPM) have evolved, focusing on macroscopic complete resection.
  • Extrapleural pneumonectomy (EPP) and extended pleurectomy/decortication (P/D) are primary surgical approaches.
  • Both techniques have distinct complication profiles and recurrence patterns.

Purpose of the Study:

  • To review and compare surgical techniques for MPM.
  • To evaluate prognostic factors in MPM treatment.
  • To determine the optimal surgical approach for MPM.

Main Methods:

  • Review of surgical techniques: EPP versus P/D.
  • Analysis of associated mortality, morbidity, and recurrence patterns.
  • Evaluation of prognostic factors including histology, lymph node metastasis, and multimodality treatment completion.

Main Results:

  • EPP is associated with higher mortality and specific complications (arrhythmias, PE, fistula, failure).
  • P/D frequently results in prolonged air leak.
  • Locoregional recurrence is more common after P/D; EPP recurrence occurs more distally. Hemithoracic radiation can reduce EPP locoregional recurrence.
  • Epithelioid histology, extrapleural lymph node metastasis, and completed multimodality treatment are prognostic factors.
  • Neither EPP nor P/D, nor specific multimodality protocols, were found to be independently prognostic.

Conclusions:

  • The choice between EPP and P/D in MPM treatment should prioritize the less morbid procedure.
  • P/D represents a logical choice for MPM treatment based on current evidence, balancing efficacy with reduced patient risk.
  • Further research may refine prognostic indicators and treatment strategies for MPM.