Extrapleural pneumonectomy with reconstruction of diaphragm and pericardium using autologous materials.

The procedures and results for extrapleural pneumonectomy through a lower door open thoracotomy with reconstruction of the diaphragm and the pericardium using a reversed latissimus dorsi muscle flap and a fascia lata graft, respectively, for the treatment of malignant pleural mesothelioma are reported. A posterolateral thoracotomy was extended along the anterior costal arch with cutting of the sixth to ninth costal cartilages. Defects of the diaphragm and the pericardium were reconstructed using reversed latissimus dorsi muscle flaps and fascia lata grafts, respectively. We conducted this procedure for seven patients with malignant pleural mesothelioma, with successful outcome.