# Decortication

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Surgical removal of a protective outer layer of an organ

Medical intervention

Decortication ICD-9-CM 34.51-34.52 [edit on Wikidata]

**Decortication** is a [medical](/source/Medicine) procedure involving the [surgical](/source/Surgery) removal of the surface layer, [membrane](/source/Biological_membrane), or fibrous cover of an [organ](/source/Organ_(anatomy)). The procedure is usually performed when the [lung](/source/Lung) is covered by a thick, inelastic [pleural peel](/source/Pulmonary_pleura) restricting lung expansion. In a non-medical aspect, decortication is the removal of the bark, husk, or outer layer, or peel of an object.[1] It may also be done in the treatment of [chronic laryngitis](/source/Chronic_laryngitis). It is the primary treatment for [fibrothorax](/source/Fibrothorax).

## Procedure

Decortication is performed under general [anaesthesia](/source/Anaesthesia). It is a major thoracic operation that has traditionally required a full [thoracotomy](/source/Thoracotomy). Since the early 1990s this procedure has increasingly been performed using more minimally invasive [thoracoscopy](/source/Thoracoscopy). All fibrous tissue is removed from the visceral pleural peel and [pus](/source/Pus) is subsequently drained from the pleural space.[2]

## Contraindications

Other than the overall health of the patients, there are no absolute contraindications. In some lung-disease patients, the lung will not expand after removal of the pleural peel, rendering the surgery futile. Other diseases that render decortication futile are narrowing of the large airway stenosis and uncontrolled pleural infection. With these conditions, the lung will not expand to fill the thorax space. A major surgery called a pleuropneumonectomy can be the only available option, but only if the patient has been worked up before the surgery. Pleuropneumonectomy is a major surgery with a very high mortality and high invasiveness.[3]

## References

1. **[^](#cite_ref-1)** [*The American Heritage Dictionary of the English Language, Fourth Edition*](http://www.bartleby.com/61/6/D0080600.html) [Archived](https://web.archive.org/web/20080302160913/http://www.bartleby.com/61/6/D0080600.html) 2008-03-02 at the [Wayback Machine](/source/Wayback_Machine). Copyright © 2000 by Houghton Mifflin Company. Published by the Houghton Mifflin Company

1. **[^](#cite_ref-2)** Sharma, Dr. Sat (2006-06-23). ["Pulmonary Empyema"](http://www.emedicine.com/MED/topic659.htm). *[WebMD](/source/WebMD)*. Retrieved 2007-02-18.

1. **[^](#cite_ref-3)** ["Decortication: Background, Indications, Contraindications"](https://emedicine.medscape.com/article/1970123-overview#a3). 2018-03-21.

v t e Tests and procedures involving the respiratory system Surgery Upper RT nose Rhinoplasty Septoplasty Somnoplasty Alarplasty Rhinectomy Rhinomanometry Acoustic rhinometry sinus Sinusotomy larynx Laryngoscopy Laryngectomy Laryngotomy Thyrotomy Laryngotracheal reconstruction Lower RT trachea Cricothyrotomy Tracheoesophageal puncture Tracheotomy bronchus Bronchoscopy lung Pneumonectomy Lobectomy Wedge resection Transplantation Decortication Heart–lung transplant Chest wall, pleura, mediastinum, and diaphragm pleura/pleural cavity Thoracentesis Pleurodesis Thoracoscopy Thoracotomy Chest tube mediastinum Mediastinoscopy Nuss procedure Tests Medical imaging Bronchography CT pulmonary angiogram High-resolution computed tomography Spiral CT Ventilation/perfusion scan Clinical prediction rule Pneumonia severity index CURB-65 Lung function test Body plethysmography Spirometry Bronchial challenge test Capnography Diffusion capacity Impulse oscillometry Cytology Bronchoalveolar lavage Nasopharyngeal swab Sputum culture Other Blood gas test Pneumography Other procedures Oxygen therapy Intubation Surgical airway management Mechanical ventilation Negative pressure ventilator Positive pressure ventilation Respiratory therapy Artificial respiration CPR Hyperbaric medicine Decompression chamber Heliox Nebulizer Postural drainage Hyperinflation therapy Pulmonary hygiene Pulmonary rehabilitation

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Adapted from the Wikipedia article [Decortication](https://en.wikipedia.org/wiki/Decortication) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Decortication?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.