What surgical procedure is indicated when lung decortication is needed?

Lung decortication is a surgical procedure performed to remove a layer of fibrous tissue that develops on the surface of the lungs, often as a result of infection, inflammation, or after physical trauma. This fibrous layer, known as a pleural peel, can restrict lung expansion and impair respiratory function.

The procedure of choice in this case is thoracotomy, which involves making a large incision in the chest wall to access the pleural cavity. Through this approach, the surgeon can effectively visualize and remove the thickened pleura, allowing the lungs to fully expand and function properly again.

While other options like thoracentesis, chest tube insertion, and video-assisted thoracoscopic surgery may be used for various thoracic issues, they are not the primary approach when significant resection of fibrous tissue is necessary, as is the case with lung decortication. Thoracentesis is typically a diagnostic or therapeutic procedure to remove excess fluid from the pleural space, chest tube insertion is often for drainage of fluid or air, and video-assisted thoracoscopic surgery can be less invasive but may not provide the necessary access and visibility required for extensive decortication. Thus, thoracotomy is the most appropriate surgical intervention for lung dec