Is diffuse malignant mesothelioma serious?

People are always busy with their work, and in recent years, the number of patients suffering from diffuse malignant mesothelioma has increased. But even so, it still cannot stop those who are busy with their work all day to stop and take care of their bodies, because some people don’t know so much about diffuse malignant mesothelioma, and of course they don’t know that this disease actually has a great impact on the human body in certain aspects. So, is diffuse malignant mesothelioma serious?

It can cause chest pain, shortness of breath, and weight loss. The harm of diffuse malignant mesothelioma is very serious and can directly affect life safety. The average survival time of patients with malignant pleural mesothelioma from the onset of symptoms to death is only 11.4 months, and most patients die within 1 year.

1. Palliative treatment of pleural effusion in patients with malignant pleural mesothelioma. Pleural effusion will reappear soon after puncture and aspiration. Chemical agents are injected into the pleural cavity to cause pleural adhesion. Pleural effusion in most patients can be controlled. Therefore, if pleurodesis fails or in patients who are scheduled for diagnostic thoracotomy, pleural decortication should be considered.

Malignant pleural mesothelioma can spread along the puncture hole, chest tube channel and thoracotomy incision, but the subcutaneous deposits caused rarely cause symptoms, so no treatment is required. If the patient is treated, these subcutaneous nodules can also be used as an indicator to observe the efficacy.

Chest pain in patients with malignant pleural mesothelioma is the most difficult symptom to treat. It is particularly severe in the late stage, persists all day long, and has no response to radiotherapy. Sufficient sedatives and analgesics, including opioids, should be given to relieve pain and help them spend the last moments of their lives safely.

2. Surgical treatment There are various surgical measures for the treatment of malignant pleural mesothelioma. The first is extended pleuropulmonary resection, which is radical resection of the affected part of the chest wall, the whole lung, diaphragm, mediastinum and pericardium. This procedure is only applicable to stage I functional epithelial malignant pleural mesothelioma cases. Severe cardiopulmonary impairment is a contraindication for this procedure.

A standard posterolateral thoracotomy incision is made at the 4th intercostal space, and the tough and thickened parietal pleura and tumor nodule are bluntly peeled off from the chest wall. This operation will cause extensive bleeding, which can be carefully and thoroughly stopped by compression, electrocautery, and suture. Then, the mediastinal pleura is separated from the top of the hilum, and the paratracheal lymph nodes are removed. Anteriorly, at the level of the lung apex, the internal mammary artery and vein are ligated, and all visible lymph nodes are removed from the anterior chest wall along with these vessels and the pleura.

Posteriorly, the paraesophageal and tracheal carina lymph nodes are removed. The pericardium was cut open from the corresponding part behind the left side. At this time, it is necessary to decide whether to remove the lung first or the diaphragm first. The order depends on the site of tumor invasion and the extent of its extension. The hilum and vessels and bronchi are transected and managed as in any intrapericardial (extended) pneumonectomy. The lower part of the pleura is not as low as the diaphragm, so after freeing the pleura, the diaphragm can be removed outside the lower pleural fold. For full exposure, a second incision is usually made between the 8th and 10th intercostal spaces on the same side.

Because the patient is placed in the lateral position during the operation, after the diaphragm is removed, the liver tends to shift from the upper side to the mediastinum, compressing the inferior vena cava and causing heart and blood flow disorders. After the diaphragm is removed, the defect can be repaired with Maxlex mesh or polyester silica material, and some people use dura mater to repair it. Regardless of the materials and techniques used, they must be airtight to prevent blood or pleural effusion from flowing from the thoracic cavity into the abdominal cavity; the diaphragm substitute should be firmly sutured to the residual edge of the diaphragm using a continuous suture method to prevent abdominal organs from protruding or herniating into the chest cavity. Before closing the chest, the chest tube should be connected to the suction device for negative pressure suction. The surgical mortality rate of extended pleuropulmonary resection is 10% to 25%, but the therapeutic effect is not better than pleurectomy, so it is not recommended for widespread use.

The above is a detailed introduction to the question of whether diffuse malignant mesothelioma is serious. I hope this can draw the attention of some patients. If this disease is not treated in time, it will cause great harm to the human body. Don’t sacrifice your health for the sake of making money. Everyone knows that a good health is the basis for making money.