Overview
Decortication is a surgical procedure performed to remove the thickened, fibrous layer (pleural peel) from the surface of the lungs. This procedure is typically indicated for patients suffering from chronic empyema (pus in the pleural cavity), fibrothorax, or pleural thickening, which can restrict lung expansion and impair respiratory function.
In South Korea, decortication is performed in advanced thoracic surgery centers and hospitals using modern surgical techniques, including minimally invasive approaches, to restore lung function, relieve symptoms, and improve patient quality of life.
What is Decortication?
Decortication involves removing the restrictive fibrous tissue (pleural peel) that prevents the lung from expanding properly. The procedure allows the lung to re-expand, improving oxygenation and respiratory function.
Indications include:
- Chronic empyema with trapped lung
- Fibrothorax caused by infection or inflammation
- Pleural thickening limiting lung expansion
- Persistent pleural effusion resistant to drainage
- Complications after trauma or thoracic surgery
Purpose:
- Restore normal lung expansion
- Relieve shortness of breath and chest discomfort
- Improve oxygenation and pulmonary function
- Prevent progression to chronic lung damage
What are the Benefits?
Decortication provides several functional and clinical benefits:
✔ Restores lung expansion and improves breathing.
✔ Reduces chronic infection risk associated with empyema.
✔ Alleviates chest pain and discomfort.
✔ Prevents long-term pulmonary complications such as fibrothorax.
✔ Improves quality of life and exercise tolerance.
Procedure Details
1) How should I prepare for Decortication?
- Medical evaluation: Blood tests, chest X-ray, CT scan, pulmonary function tests
- Medication review: Adjustments for anticoagulants or other medications affecting surgery
- Preoperative counseling: Discuss anesthesia options, surgical approach, risks, benefits, and expected recovery
- Respiratory preparation: Breathing exercises to optimize lung function
- Consent: Understanding the surgical procedure, potential complications, and postoperative care
South Korean thoracic surgery centers provide personalized preoperative planning and pulmonary rehabilitation programs to ensure optimal outcomes.
2) What happens during Decortication?
- Anesthesia: General anesthesia with endotracheal intubation
- Surgical approach:
- Open thoracotomy: Traditional method for extensive pleural peel removal
- Video-assisted thoracoscopic surgery (VATS): Minimally invasive technique using small incisions and thoracoscope
- Pleural peel removal: The fibrous layer is carefully dissected from the lung surface to allow full lung re-expansion
- Drain placement: Chest tubes are placed to drain fluid and air postoperatively
- Duration: Typically 2–4 hours, depending on the extent of disease
South Korean surgeons employ precise dissection techniques and advanced visualization tools to minimize lung trauma and maximize functional recovery.
3) What happens after Decortication?
- Immediate post-op: Monitoring in ICU or high-dependency unit; management of chest tubes, pain, and fluids
- Pain management: Epidural, IV, or oral analgesics to manage post-surgical discomfort
- Pulmonary care: Breathing exercises and physiotherapy to promote lung expansion
- Follow-up: Imaging to ensure lung re-expansion and monitor for complications
- Activity: Gradual mobilization; respiratory exercises continued during recovery
Risks / Benefits
Potential Risks:
- ➤ Bleeding or hematoma formation
- ➤ Infection, including pneumonia or wound infection
- ➤ Air leaks or prolonged chest tube drainage
- ➤ Respiratory complications such as atelectasis or hypoxemia
- ➤ Pain and discomfort at incision sites
Major Benefits:
- ✔ Restores lung expansion and pulmonary function
- ✔ Reduces infection risk associated with empyema
- ✔ Alleviates chest pain and improves breathing
- ✔ Minimally invasive options reduce recovery time
- ✔ Prevents chronic lung damage and fibrothorax progression
Recovery and Outlook
- Immediate: ICU or recovery unit monitoring; chest tubes in place for 3–7 days
- 1–2 weeks: Pain management and gradual mobilization; lung function improves
- 4–6 weeks: Most patients resume normal daily activities; full lung expansion expected
- Long-term: Improved respiratory function, reduced infections, and enhanced quality of life
South Korean hospitals provide comprehensive post-operative care including pulmonary rehabilitation, physiotherapy, and follow-up imaging for optimal recovery.
When To Call the Doctor
Contact your thoracic surgeon if you notice:
- ➤ Persistent or worsening shortness of breath
- ➤ Fever, chills, or signs of infection
- ➤ Excessive drainage from chest tubes or incision
- ➤ Severe chest pain not relieved by medications
- ➤ Any unusual symptoms affecting respiratory function
Best Korea Option / Process
South Korea offers advanced decortication services due to:
- Experienced thoracic surgeons and multidisciplinary teams
- Minimally invasive VATS techniques for reduced pain and faster recovery
- Comprehensive perioperative and ICU care
- Pulmonary rehabilitation programs to restore full lung function
- International patient support with scheduling, translation, and follow-up
- High safety standards and excellent long-term outcomes
Top hospitals for Decortication in Korea:
- Samsung Medical Center, Seoul – Thoracic Surgery Department
- Asan Medical Center, Seoul – Pulmonary & Thoracic Surgery
- Severance Hospital (Yonsei University Health System) – Thoracic Surgery
- Seoul National University Hospital – Advanced Lung Surgery Division
