Malignant pleural mesothelioma prognosis is still dire. Since results are not
optimal via single modality protocols, combined treatments have been proposed with
more encouraging results. However, the likelihood of severe complications should be
taken into the account. In this chapter, we will discuss complications due to the surgical
treatment. In particular, cardiovascular complications are frequently encountered after
mesothelioma surgery. Atrial fibrillation may occur in more than 50% of patients after
extrapleural pneumonectomy. Myocardial infarction and serious ventricular arrhythmias
are seen more rarely. Respiratory complications may include prolonged air-leak, ARDS
and pneumonia. Meticulous surgical technique, proper anesthetic management with
preoperative fluid restriction, and early mobilization are of paramount importance to
decrease postoperative morbidity.
Keywords: Complications, extrapleural pneumonectomy, postoperative
morbidity, Thoracic Surgery.
