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Disorders of the Chest Wall, An Issue of Thoracic Surgery Clinics, E-Book

Disorders of the Chest Wall, An Issue of Thoracic Surgery Clinics, E-Book

Henning A. Gaissert

(2017)

Additional Information

Abstract

This issue of Thoracic Surgery Clinics, guest edited by Dr. Henning A. Gaissert, is devoted to The Chest Wall. Dr. Gaissert has assembled expert authors to review the following topics: Acute Infections of the Chest Wall; Chronic Infections of the Chest Wall; Thoracoplasty for TB in the 21st Century; Chest Wall Trauma: Conservative Management and Surgical Reconstruction; Minimally Invasive Repair of the Pectus Excavatum/Carinatum; Surgical Implications of the Straight Back Syndrome; Management of Primary Soft Tissue Tumors of the Chest Wall; Management of Lung Cancer Invading the Superior Sulcus; Management of Breast Cancer Invading the Chest Wall; Chest Wall Reconstruction without Prosthetic Material; Surgical Management of the Radiated Chest Wall and its Complications; Surgical Management of Primary Tumors of the Osseous Chest Wall; Surgical Management of Lung Cancer Involving the Chest Wall; Prosthetic Reconstruction of the Chest Wall, and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Disorders of theChest Wall i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents v
Preface v
Acute Chest Wall Infections: Surgical Site Infections, Necrotizing Soft Tissue Infections, and Sternoclavicular Joint Infection v
Chronic Infections of the Chest Wall v
Thoracoplasty for Tuberculosis in the Twenty-first Century v
Chest Wall Trauma v
Minimal Invasive Repair of Pectus Excavatum and Carinatum vi
Straight Back Syndrome vi
Management of Primary Soft Tissue Tumors of the Chest Wall vi
Management of Lung Cancer Invading the Superior Sulcus vi
Management of Breast Cancer Invading Chest Wall vii
Chest Wall Reconstruction Without Prosthetic Material vii
Surgical Management of the Radiated Chest Wall and Its Complications vii
Primary Tumors of the Osseous Chest Wall and Their Management vii
Surgical Management of Lung Cancer Involving the Chest Wall vii
Prosthetic Reconstruction of the Chest Wall viii
THORACIC SURGERY CLINICS\r ix
FORTHCOMING ISSUES ix
August 2017 ix
November 2017 ix
February 2018 ix
RECENT ISSUES ix
February 2017 ix
November 2016 ix
August 2016 ix
Preface xi
Acute Chest Wall Infections 73
Key points 73
POSTOPERATIVE SURGICAL SITE INFECTION OF ANTERIOR, LATERAL, OR POSTERIOR THORACOTOMY 73
SMOKING CESSATION AND SURGICAL SITE INFECTIONS 75
TREATMENT OF SUPERFICIAL SURGICAL SITE INFECTION 75
TREATMENT OF DEEP SURGICAL SITE INFECTIONS OF THE THORAX 76
TREATMENT OF ORGAN/SPACE SURGICAL SITE INFECTIONS 76
NEGATIVE PRESSURE WOUND THERAPY AND VACUUM-ASSISTED CLOSURE 77
Can a Vacuum Dressing Be Used to Manage a Deep Surgical Site Infection of a Thoracotomy Incision? 77
How Are Chest Drains Managed in Conjunction with a Vacuum Dressing? 78
Can a Vacuum Dressing Be Used in a Window Thoracostomy? 78
Can a Vacuum Dressing Be Placed on the Lung? 78
Can a Vacuum Dressing Be Placed on the Mediastinum/Bronchial Stump? 79
NECROTIZING SOFT TISSUE INFECTION 79
DIAGNOSIS AND TREATMENT 80
STERNOCLAVICULAR JOINT INFECTION 81
DIAGNOSIS 81
Why Is This Joint Predisposed to Infections and What Is the Potential Loss of Function from Removing the Sternoclavicular J ... 81
Does Treatment of an Infected Joint Require Debridement or Resection, or Can Antibiotic Therapy Alone Suffice? 82
Once the Joint Is Removed, What Is the Optimal Method of Closing the Defect? 83
SUMMARY 84
REFERENCES 84
Chronic Infections of the Chest Wall 87
Key points 87
INTRODUCTION 87
CARTILAGE AND BONE INFECTIONS 88
Costochondral Infection 88
Tubercular abscesses 88
Osteomyelitis of the Chest Wall 89
Osteomyelitis of the Sternum 90
Osteomyelitis of the Ribs 90
Osteomyelitis of the Sternoclavicular Joint 90
CHRONIC INFECTIONS OF THE CHEST WALL SOFT TISSUES 93
Empyema Necessitans 93
Chest Wall Actinomycosis 93
Fungal Infections 94
Chronic Parasitic Infections 94
MANAGEMENT OF SURGICAL WOUNDS RESULTING FROM CHRONIC CHEST WALL INFECTIONS 95
Negative-Pressure Wound Therapy 95
Chest Wall Reconstruction 95
SUMMARY 96
REFERENCES 96
Thoracoplasty for Tuberculosis in the Twenty-first Century 99
Key points 99
INTRODUCTION 99
TOPOGRAPHIC-ANATOMIC JUSTIFICATION OF MINIMALLY INVASIVE APPROACH FOR OSTEOPLASTIC THORACOPLASTY 100
THE SURGICAL TECHNIQUE 100
INDICATIONS FOR OSTEOPLASTIC THORACOPLASTY 103
CONTRAINDICATIONS FOR OSTEOPLASTIC THORACOPLASTY 103
CLINICAL OUTCOMES 103
COMPLICATIONS AND CONCERNS 105
OUTCOME OF THE STUDY 106
A CLINICAL CASE STUDY 106
SUMMARY 110
REFERENCES 110
Chest Wall Trauma 113
Key points 113
INTRODUCTION 113
HISTORICAL PERSPECTIVE 113
MECHANISMS OF INJURY 114
ANATOMIC CONSIDERATIONS 114
INITIAL MANAGEMENT 114
RADIOGRAPHIC DIAGNOSIS 114
MANAGEMENT OF CHEST WALL INJURIES 114
Rib Fractures/Flail Chest 114
Pain Management 115
Lidocaine patches 115
Thoracic epidural catheters 115
Intercostal nerve blocks with or without a continuous infusion catheter 115
Management of Pulmonary Dysfunction 115
Surgical Management 116
Sternal Fractures 119
REFERENCES 119
Minimal Invasive Repair of Pectus Excavatum and Carinatum 123
Key points 123
INTRODUCTION 123
PECTUS EXCAVATUM 123
Patient Selection 124
Preoperative Assessment 124
Surgical Technique 124
Preparation and positioning 124
Surgical approach 124
Immediate Postoperative Care 126
Rehabilitation and Recovery 127
Clinical Results 127
Vacuum Bell Treatment 127
Pectus-up 128
PECTUS CARINATUM 128
Introduction 128
Brace Treatment 128
Patient Selection 128
Technique 128
MINIMAL INVASIVE SURGICAL TREATMENT: THE ABRAMSON TECHNIQUE 129
Patient Selection 129
Preparation and Patient Positioning 129
Surgical Approach 129
Immediate Postoperative Care 130
Rehabilitation and Recovery 130
Clinical Results 130
Modifications 130
REFERENCES 130
Straight Back Syndrome 133
Key points 133
REFERENCES 137
Management of Primary Soft Tissue Tumors of the Chest Wall 139
Key points 139
INTRODUCTION 139
DIAGNOSIS 139
Benign Soft Tissue Tumors 140
Lipoma 140
Lipoblastoma 141
Hemangioma 141
Benign peripheral nerve sheath tumors: neurofibromas/schwannomas 141
Desmoid tumors 141
Malignant Soft Tissue Tumors 142
Sarcomas 142
Malignant fibrous histiocytoma 143
Synovial sarcoma 143
Rhabdomyosarcoma 143
Fibrosarcoma 144
PRINCIPLES OF SURGERY 144
CHEMOTHERAPY AND RADIATION THERAPY FOR SARCOMAS 144
SUMMARY 145
REFERENCES 145
Management of Lung Cancer Invading the Superior Sulcus 149
Key points 149
HISTORY 149
DEFINITION 150
CLINICAL PRESENTATION 150
DIAGNOSIS 150
PATHOLOGY 151
STAGING 152
TREATMENT 152
SURGICAL APPROACHES 154
SUMMARY 155
REFERENCES 155
Management of Breast Cancer Invading Chest Wall 159
Key points 159
INTRODUCTION 159
SURGICAL PRINCIPLES FOR THE MANAGEMENT OF BREAST CANCER INVOLVING THE CHEST WALL 160
CLINICAL OUTCOMES 161
COMPLICATIONS AND CONCERNS 162
SUMMARY 163
REFERENCES 163
Chest Wall Reconstruction Without Prosthetic Material 165
Key points 165
INTRODUCTION 165
INDICATIONS FOR CHEST WALL RESECTION AND RECONSTRUCTION 165
CLASSIFICATION OF MUSCLE FLAPS 166
LATISSIMUS DORSI MUSCLE FLAP 166
PECTORALIS MAJOR MUSCLE FLAP 167
SERRATUS ANTERIOR MUSCLE FLAP 168
RECTUS ABDOMINIS MUSCLE FLAP 168
EXTERNAL OBLIQUE MUSCLE FLAP 168
CLINICAL RESULTS OF CHEST WALL RESECTION WITHOUT PROSTHETIC RECONSTRUCTION 168
SUMMARY 169
REFERENCES 169
Surgical Management of the Radiated Chest Wall and Its Complications 171
Key points 171
SURGICAL RESECTION OF THE IRRADIATED CHEST WALL 172
OSTEONECROSIS OF THE CHEST WALL 172
Case Presentation 173
RADIATION-INDUCED SOFT TISSUE AND BONE CANCERS OF THE CHEST WALL 174
Diagnosis 176
Diagnostic Criteria 176
Staging 176
Prognosis 176
Treatment 177
Operative Technique 177
Adjuvant Therapy 177
REFERENCES 178
Primary Tumors of the Osseous Chest Wall and Their Management 181
Key points 181
INTRODUCTION 181
CLASSIFICATION 181
CLINICAL PRESENTATION 182
EVALUATION 182
History and Physical Examination 182
Imaging 182
Tissue Diagnosis 183
BENIGN TUMORS 183
Osteochondroma (Osteocartilaginous Exostosis) 183
Clinical features 183
Radiographic finding 183
Surgical Management of Lung Cancer Involving the Chest Wall 195
Key points 195
INTRODUCTION 195
CLINICAL PRESENTATION 196
PRINCIPLES OF SURGICAL TREATMENT 196
ROLE OF SURGERY FOLLOWED BY ADJUVANT THERAPY 197
ROLE OF MULTIMODALITY THERAPY 197
PROGNOSTIC FACTORS 198
SUMMARY 198
REFERENCES 198
Prosthetic Reconstruction of the Chest Wall 201
Key points 201
INTRODUCTION 201
INDICATIONS FOR RECONSTRUCTION 201
PROSTHETIC MATERIALS AVAILABLE 202
Synthetic Meshes and Patches 203
Biological Mesh 204
Osteosynthesis Systems 204
SURGICAL TECHNIQUE 205
CLINICAL OUTCOMES 205
SUMMARY 208
REFERENCES 208
Index 209