PLEURECTOMY FOR PERSISTENT PAIN IN BENIGN ASBESTOS-RELATED PLEURAL DISEASE

Background - Persistent severe pain is a rare complication of benign a sbestos-related pleural disease. Methods - Four patients are described in whom pain persisted for more than one year (range 18 months to fiv e years) which was incompletely relieved by opioid medication and nerv e blocking procedures. All underwent pleurectomy in an attempt to reli eve it. Results - At operation the pleura was considerably thickened i n all cases. Two of the four patients had successful relief of pain. T he other two had a neuralgic component to their pain before surgery wh ich persisted afterwards. One of these patients underwent successful c ervical cordotomy. Conclusions - Pleurectomy may provide relief in pat ients with constant pleuritic pain due to benign asbestos-related pleu ral thickening. It seems, however, that patients in whom the pain has a neuralgic component are unlikely to benefit.