Aerostasis to limit air-leak following extended pleurectomy-decortication.

Extended pleurectomy-decortication is a cytoreductive surgical treatment for malignant pleural mesothelioma. Prolonged air-leak remains a major postoperative challenge lengthening hospital stay and increasing morbidity. In this video report we present a stepwise approach for visceral decortication, and introduce the concept of aerostasis by construction of an artificial neopleura. Our results suggest that improved aerostasis results in shortened air-leak duration.