The Annals of Thoracic Surgery, Vol 40, 82-96, Copyright © 1985 by The Society of Thoracic Surgeons
Thoracic surgical problems in asbestos-related disorders
EA Gaensler, TC McLoud and CB Carrington
Among 1,577 persons with asbestos exposure followed up from 3 to 30 years,
113 had thoracic surgical procedures for asbestos-related disorders.
Twenty-six individuals suspected of having asbestosis with atypical
features underwent open-lung biopsy; a different disease was revealed in
14. Most of the 29 patients with mesothelioma had a small thoracotomy for
diagnosis only; chemotherapy in half of them proved entirely ineffective.
Experience with 23 patients with bronchogenic carcinoma did not differ from
that in persons not exposed to asbestos. Problems of causal relationship
are discussed. Most of the 68 individuals with benign asbestos pleural
effusion had no symptoms, but because of recurrence, 15 were operated on
for decortication or for possible mesothelioma. Hyaline plaques often were
mistaken for lung, rib, or diaphragmatic tumors, and sometimes mesothelioma
was suspected. Operative intervention in the 24 patients with plaques could
have been avoided by obtaining a more detailed occupational history and
reviewing previous chest roentgenograms, which invariably showed identical
or smaller plaques from 2 to 17 years earlier.
