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Thoracic Surgery in the Special Care Patient, An Issue of Thoracic Surgery Clinics, E-Book

Thoracic Surgery in the Special Care Patient, An Issue of Thoracic Surgery Clinics, E-Book

Sharon Ben-Or

(2017)

Additional Information

Book Details

Abstract

This issue of Thoracic Surgery Clinics of North America, guest edited by Dr. Sharon Ben-Or, is devoted to Thoracic Surgery in the Special Care Patient. Dr. Ben-Or has assembled expert authors to review the following topics: Thoracic surgery in the pregnant patient; Thoracic surgery in early stage small cell lung cancer; Lung cancer in the post transplant / immunosuppressed patient; The postpneumonectomy patient; Thoracic surgery considerations in the obese patient; Thoracic surgery considerations in the pediatric patient; Esophagectomy after weight reduction surgery; Thoracic surgery considerations in the mentally ill or handicapped patient; Lung cancer with concomitant cardiac disease; Malignant pleural effusion and the trapped lung; Empyema from an obstructing lung cancer; Synchronous esophageal and lung cancer; Thoracic surgery considerations in the AIDS patient; and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Thoracic Surgery in the Special Care Patient\r i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents v
Preface: Thoracic Surgery in the Special Care Patient v
Thoracic Surgery in the Pregnant Patient v
Thoracic Surgery in Early-Stage Small Cell Lung Cancer v
Lung Cancer and Lung Transplantation v
Lung Resection in the Postpneumonectomy Patient v
Thoracic Surgery Considerations in Obese Patients v
Thoracic Surgery Considerations in the Child and Young Adult vi
Esophagectomy After Weight-Reduction Surgery vi
Thoracic Surgery Considerations in the Mentally Ill or Handicapped Patient vi
Management of Lung Cancer with Concomitant Cardiac Disease vi
Management of Malignant Lung Entrapment, the Oncothorax vii
Empyema from Obstructing Lung Cancer vii
Synchronous Esophageal and Lung Cancer vii
Thoracic Surgery in Patients with AIDS vii
THORACIC SURGERY CLINICS\r viii
FORTHCOMING ISSUES viii
May 2018 viii
August 2018 viii
November 2018 viii
RECENT ISSUES viii
November 2017 viii
August 2017 viii
May 2017 viii
Preface:\rThoracic Surgery in the Special Care Patient ix
Thoracic Surgery in the Pregnant Patient 1
Key points 1
INTRODUCTION 1
DIAGNOSTIC IMAGING 1
PERIOPERATIVE ISSUES 2
PREDOMINANT THORACIC CONDITIONS SEEN DURING PREGNANCY 3
Empyema 3
Spontaneous Pneumothorax 3
Diaphragmatic Hernia 4
LUNG CANCER IN PREGNANCY 4
SHARED DECISION MAKING 5
REFERENCES 6
Thoracic Surgery in Early-Stage Small Cell Lung Cancer 9
Key points 9
INTRODUCTION: NATURE OF THE PROBLEM 9
THERAPEUTIC OPTIONS AND SURGICAL TECHNIQUES 9
Epidemiology 9
Staging of small cell lung cancer 10
Small Cell Lung Cancer Treatment Options 10
CLINICAL OUTCOMES 11
Surgery versus Nonoperative Management 11
Type of Surgery 11
Standard of Care for Stage I Small Cell Lung Cancer 11
Future Directions 12
SUMMARY 12
REFERENCES 12
Lung Cancer and Lung Transplantation 15
Key points 15
INTRODUCTION 15
LUNG CANCER AS AN INDICATION FOR TRANSPLANT 15
LUNG CANCER IN THE TRANSPLANTED AND CONTRALATERAL NATIVE LUNG 17
INCIDENTAL FINDING OF LUNG CANCER IN THE EXPLANTED LUNG 17
SUMMARY 18
REFERENCES 18
Lung Resection in the Postpneumonectomy Patient 19
Key points 19
INTRODUCTION 19
SELECTION OF PATIENTS FOR RESECTION 20
Functional Status and Cardiopulmonary Evaluation 20
Assessment of Tumor Extent 20
SURGICAL TECHNIQUE 21
Anesthetic Management 21
Surgical Procedure 21
OUTCOMES 21
ALTERNATIVES TO SURGICAL MANAGEMENT 23
SUMMARY 23
REFERENCES 23
Thoracic Surgery Considerations in Obese Patients 27
Key points 27
INTRODUCTION 27
PREOPERATIVE ASSESSMENT OF COMORBIDITIES AND RISK FACTORS FOR SURGERY 28
GENERAL ANESTHESIA IN OBESE PATIENTS 31
OPERATIVE PLANNING AND CONSIDERATIONS 32
POSTOPERATIVE MANAGEMENT 34
OUTCOMES IN LUNG AND ESOPHAGEAL CANCER 36
SUMMARY 36
REFERENCES 36
Thoracic Surgery Considerations in the Child and Young Adult 43
Key points 43
INTRODUCTION 43
EMBRYOLOGY 44
Diagnosis 44
Complete vascular rings 45
Innominate artery compression 46
Pulmonary artery sling 46
Other vascular abnormalities 46
CONGENITAL CARDIAC MALFORMATIONS 46
PRIMARY DISORDERS OF THE TRACHEA AND BRONCHUS 47
Primary Tracheomalacia 48
Acquired or Secondary Tracheomalacia 48
TRACHEAL WEBS 49
CONGENITAL TRACHEAL STENOSIS 49
TRACHEAL CARTILAGINOUS SLEEVE 50
AGENESIS AND ATRESIA OF THE TRACHEA 51
OTHER RARE ANOMALIES 51
SUMMARY 51
REFERENCES 52
Esophagectomy After Weight-Reduction Surgery 53
Key points 53
INTRODUCTION 53
TECHNICAL CONSIDERATIONS 54
Roux-en-Y Gastric Bypass 54
Laparoscopic Gastric Sleeve Resection 55
Band Gastroplasty 56
OTHER CONSIDERATIONS 56
Approach to Perform the Esophagectomy: Open, Minimally Invasive, or Robotic? 56
Should Patients Undergoing Bariatric Procedures be Screened for Esophageal Cancer? 57
SUMMARY 57
ACKNOWLEDGMENTS 57
REFERENCES 57
Thoracic Surgery Considerations in the Mentally Ill or Handicapped Patient 59
Key points 59
INTRODUCTION 59
RESPIRATORY FAILURE AND AIRWAY MANAGEMENT 60
Case 1 60
Discussion 60
BENIGN FOREGUT DISEASE 62
Case 2 62
Case 3 62
Discussion 63
THORACIC MALIGNANCY 65
Case 4 65
Discussion 65
SUMMARY 67
SUPPLEMENTARY DATA 67
REFERENCES 67
Management of Lung Cancer with Concomitant Cardiac Disease 69
Key points 69
INTRODUCTION: NATURE OF THE PROBLEM 69
PATIENT POPULATION AND PRESENTATION 70
PREOPERATIVE ASSESSMENT 70
THERAPEUTIC OPTIONS AND/OR SURGICAL TECHNIQUE 71
Percutaneous Coronary Intervention 71
Staged Versus Combined Procedures 71
Operative Approach 73
Sternotomy versus thoracotomy 73
On-Pump Versus Off-Pump 74
With Cardiopulmonary Bypass (On-Pump) 74
Without Cardiopulmonary Bypass (Off-Pump) 76
SUMMARY 76
REFERENCES 77
Management of Malignant Lung Entrapment, the Oncothorax 81
Key points 81
INTRODUCTION 81
PATHOPHYSIOLOGY 82
DIAGNOSIS 82
MANAGEMENT OF RECURRENT MALIGNANT PLEURAL EFFUSION 83
Pleurodesis 83
Technique 83
Results 83
INDWELLING PLEURAL CATHETER 84
Technique 84
Results 84
Indwelling Catheter and Pleurodesis 85
PLEUROPERITONEAL SHUNT 85
MANAGEMENT OF MALIGNANT LUNG ENTRAPMENT (ONCOTHORAX) 85
PLEURECTOMY AND DECORTICATION 85
Technique 85
Results 86
DECORTICATION WITH INTRAOPERATIVE HYPERTHERMIC CHEMOPERFUSION 86
Technique 86
Results 87
INTRAPLEURAL PHOTODYNAMIC THERAPY 87
THE INFECTED ONCOTHORAX 88
SUMMARY AND RECOMMENDATIONS 88
REFERENCES 88
Empyema from Obstructing Lung Cancer 91
Key points 91
INTRODUCTION 91
PLEURAL CONDITIONS 91
Para-Malignant Effusion 91
Malignant Effusion 92
Trapped Lung 92
MANAGEMENT OPTIONS 92
Chest Tube Drainage 92
Pleural Fibrinolytic Therapy 92
Pleurodesis 93
Pleural Exploration 93
Medical Pleuroscopy 93
Video-Assisted Thoracoscopic Surgery and Open Explorations 93
Pulmonary Resection and Decortication 94
Pain Control Strategy 94
ENDOBRONCHIAL MANAGEMENT OF OBSTRUCTING TUMORS 95
Bronchoscopy 95
SUMMARY 95
REFERENCES 95
Synchronous Esophageal and Lung Cancer 97
Key points 97
INTRODUCTION 97
PERSPECTIVES: CONCOMITANT LUNG AND ESOPHAGEAL CARCINOMA IN THE LITERATURE 97
SYNCHRONOUS ESOPHAGEAL AND LUNG CANCERS: SPECIAL CONSIDERATIONS 98
Need for Accurate Diagnosis and Staging 98
Preoperative Risk Assessment: Eligibility for Surgical Treatment of Synchronous Lung and Esophageal Cancer 98
Operative Planning: Single-Stage Versus Two-Stage Esophageal Reconstruction 99
Operative Planning: Incision, Extent of Pulmonary Resection, and Buttressing Bronchial Stump 99
A Comment on Metachronous Cancers 102
SYSTEMATIC REVIEW OF THE LITERATURE 102
SUMMARY 103
REFERENCES 103
Thoracic Surgery in Patients with AIDS 105
Key points 105
INTRODUCTION 105
PNEUMOTHORAX 105
NECROTIZING ESOPHAGITIS 106
PLEURAL EFFUSION IN PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS 106
CANCER AND HUMAN IMMUNODEFICIENCY VIRUS 106
LUNG CANCER AND HUMAN IMMUNODEFICIENCY VIRUS 106
SUMMARY 107
REFERENCES 107