دانلود کتاب Thoracic surgery : cervical, thoracic and abdominal approaches

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Preface
Contents
About the Editors
Thoracic Surgery: General
General Aspects of Thoracic Surgery
Definitions
Concept of Cervical and Thoracic Border Surgery
Surgical Approaches of Cervico-Thoracic Junction Pathology
Minimally Invasive Approaches of the Cervico-Thoracic Junction Pathology
References
General Aspects of Thoracic Anesthesia
Introduction
Preoperative Evaluation and Risk Assessment
Preoperative Optimization, Prehabilitation
Inhalational Versus Total Intravenous Anesthesia (TIVA) for Thoracic Surgery
Lung Separation, Isolation and Airway Management
General Aspects of Thoracic Anesthesia
One Lung Ventilation
Pain Management
Conclusion
References
Complications in Thoracic Surgery
Introduction
Early Complications
Late Complications
References
Pain Management for the Thoracic Surgical Patient
Introduction
Post-toracotomy Pain Treatment Methods
Systemic Analgesics
Local and Regional Nerve Blocks
References
The Neck Lymphnodes
Surgical Anatomy of the Neck
Introduction
Embryology
Cervical Anatomy
Cervical Fasciae
Lymphatic System
Anatomical Lymph Node Groups
Level System of Cervical Lymph Nodes
Levels IA and IB, Submental and Submandibular Group
Levels IIA and IIB, Upper Jugular Group
Level III, Middle Jugular Group
Level IV, Lower Jugular Group
Levels VA and VB, Posterior Triangle Group
Level VI, Anterior (Central) Compartment Group
Lymphatic Drainage Patterns According the Level System
Conclusion
References
Surgical Approaches and Operative Techniques for Cervical Lymph Node Pathology
Introduction
Historical Snippet and Nomenclature
Diagnostic Considerations—Staging of the Neck
Surgical Management
Preoperative Considerations
Operative Technique
Outlook: Developing Techniques
Perioperative Accidents
Injury to Vascular Structures
Injury to Nerve Structures
Other Peri- and Postoperative Complications
Chyle Leak
Seroma
Conclusion
References
Mediastinal Lymphatic System
Embryology and Surgical Anatomy of the Mediastinal Lymphatic System
Introduction
Embryology of the Lymphatic System
Histology of the Lymphatic System
Anatomy of the Lymphatic System
Cisterna Chyli
Thoracic Duct
Origin, Trajectory, Relationships
Anatomical Variants of Thoracic Duct Spillage
Thoracic Ducts Tributaries
Right Lymphatic Duct
References
Embryology and Surgical Anatomy of the Mediastinal Lymph Nodes
Introduction
Embryology
Surgical Anatomy
Conclusion/Summary
References
Surgical Approaches and Operative Techniques for the Mediastinal Lymphatic System
Introduction
Cervical Thoracic Duct Fistula (Cervical Chylous Fistulae, Cervical Chyle Leak)
Conservative Treatment
Surgical Treatment
Intraoperative Lesion Recognition
Postoperative Lesion Recognition (Reoperation)
Chylothorax
Conservative Treatment
Specific Conservative Treatment
Hormonal Treatment
Alternative Treatment by Interventional Radiology
Thoracentesis
Surgical Treatment
Thoracic Drainage Procedure
Minimal Pleurectomy Associated with Chemical Pleurodesis
Minimally Invasive Surgical Procedures
Thoracoscopic Surgery
Video-Assisted Thoracoscopic Surgery (VATS)
Major Surgical Procedures
The Lampson Procedure
Patterson Procedure
Partial Parietal Pleurectomy
Transabdominal Ligation
Other Techniques
Pleuroperitoneal Shunt
Mechanical Ventilation
Radiotherapy
References
Surgical Approaches and Investigation Techniques to the Mediastinal Lymph Nodes
Introduction
Computed Tomography, Positron Emission Tomography and Image-Guided Biopsy
Endobronchial Ultrasound and Endoscopic Ultrasound
Videomediastinoscopy and Extended Videomediastinoscopy
Surgical Access to the Mediastinum: Anterior Mediastinotomy (“Chamberlain”), Videothoracoscopy (VATS), Sternotomy and Thoracotomy
Mediastinal Lymph Nodes During Anatomic Resection
Conclusion/Summary
References
The Thyroid Gland
Surgical Anatomy of the Thyroid Gland
Embryology
Surgical Anatomy
References
Surgical Approaches in Thyroid Pathology and Operative Techniques
Surgical Indications
Traditional Cervical Approach
Special Considerations for Combined Thoracic Approach
Complications
References
The Parathyroid Glands
Surgical Anatomy of the Parathyroid Glands
Embryology
Surgical Anatomy
References
Surgical Approaches in Parathyroid Pathology and Operative Techniques
Indications for Surgery
Traditional Cervical Approach
Special Considerations for Thoracic Approach
Complications
References
The Esophagus
Esophageal Anatomy
Introduction
Cervical Esophagus
Superior Esophageal Sphincter
Recurrent Laryngeal Nerve
Surgical Approach to the Cervical Esophagus
Thoracic Esophagus
Upper Thoracic Esophagus
Surgical Access
Middle Thoracic Esophagus
Azygos Vein
Surgical Access to the Upper and Mid Thoracic Esophagus
Lower Thoracic Esophagus
Thoracic Duct
Surgical Access to the Lower Thoracic Esophagus
Abdominal Esophagus
Esophagogastric Junction
Diaphragm Crura
Vagus Nerve
Surgical Access to the Abdominal Esophagus
References
Surgical Approaches for the Esophagus
Cervical Esophageal Surgery—Techniques
Thoracic Esophageal Surgery—Techniques
Abdominal Esophageal Surgery—Techniques
Intraoperative Accidents and Complications in the Surgery of the Esophagus
Introduction
Summary
References
The Chest Wall
The Cervico-Thoracic Spine
Introduction
Clinical Course
Indications for Surgery
Tumors
Preparation for Surgery
Position and Planes
Surgical Anatomy
Approaches and Surgical Techniques
Manubriotomy
Transthoracic Approach to Thoracic Spine
Postoperative Management
Intraoperative Accidents and Complications
Pearls and Pitfalls
Conclusions/Summary
Reference
The Superior Thoracic Aperture
Introduction
Etiology of Thoracic Outlet Syndrome
Clinical Presentation of Thoracic Outlet Syndrome
Anatomy of Thoracic Outlet
Diagnostic Work-up for Thoracic Outlet Syndrome
Computed Tomography
Magnetic Resonance Imaging
Other Imaging Studies
Nerve Conduction Studies
Anterior Scalene Muscle Blocks
Non-surgical Treatment Strategies for Thoracic Outlet Syndrome
Surgical Techniques for Thoracic Outlet Syndrome
Supraclavicular: Scalenotomy, Scalenectomy, Neurolysis, ±First Rib Resection
Transaxillary: First Rib Resection
Combined Supraclavicular and Transaxillary
Posterior: Affords Proximal Exposure to C8 and T1 Nerve Roots; Especially Useful for Revision TOS Cases
Recent Development in the Management of Thoracic Outlet Syndrome
Intraoperative Accidents and Complications
Injury to the Phrenic Nerve
Lymphorrhoea
Pleural Effusion or Pneumothorax
The Future of TOS
Conclusions/Summary
References
Surgical Techniques for Chest Wall Diseases
Introduction
Congenital Malformations
Neoplastic Disease
Conclusions
References
Trachea
Surgical Anatomy of the Trachea and the Central Bronchial Airways
References
General Aspects in the Pathology of the Trachea
Symptomology and Diagnostics
Patient Selection and Workup
Challenges for Anesthesia
References
Surgical Approaches
Cervical Trachea’s Pathology—Techniques
Thoracic Trachea’s Pathology—Techniques
References
Tracheal Resections—Intraoperative Accidents and Complications
Outcome and Follow-up After Central Airway Resection
Minimal-Invasive Approaches to the Trachea and Central Airways
References
The Lung
Embryology of the Lung
Introduction
Embryonic Period (Weeks 4–7)
Pseudoglandular Stage (Weeks 7–17)
Canalicular Stage (Weeks 16–26)
Saccular Stage (Weeks 24–38)
Alveolarization (Week 36 to Adulthood)
Conclusions/Summary
References
Congenital Malformations of the Lung
Introduction
Congenital Lobar Emphysema
Bronchial Atresia and Bronchogenic Cyst
Bronchopulmonary Sequestration
Congenital Pulmonary Airway Malformations
Diagnosis
Prenatal
Postnatal
Indication of Treatment
Prenatal
Postnatal
Therapy
Prenatal Care
Fetal Intervention
Perinatal Surgery
Postnatal Surgery
Operative Management
Summary
References
The Right Lung
Surgical Anatomy
Right Pulmonary Artery
Right Pulmonary Veins
Right Bronchial System
Right Pulmonary Lymphatic Drainage
References
The Left Lung
Introduction: General Concepts
The Left Pulmonary Artery
The Left Pulmonary Veins
The Left Bronchial System
Bronchial Arteries and Veins
The Left Bronchial Lymphatic Drainage
Anatomy
Map and Definitions of Stations
Lymphatic Drainage from the Left Lung: General Concepts
References
Minimally Invasive Right Pulmonary Resections Techniques
Introduction
VATS Definition and Approach
Anterior Approach
Uniportal Approach
Robotic Approach
Right Anatomical Resection Techniques
Right Upper Lobectomy (RUL)
Middle Lobectomy (ML)
Right Lower Lobectomy (RLL)
Superior Bilobectomy
Inferior Bilobectomy
Right Pneumonectomy
Right Sleeve Pulmonary Resection: Right Upper Lobe Sleeve Lobectomy
References
Minimally Invasive Left Pulmonary Resections Techniques
Left Anatomical Resection Techniques
Left Upper Lobectomy
Left Lower Lobectomy
Left Pneumonectomy
Left Sleeve Pulmonary Resections
Simple Bronchoplasty
Wedge Bronchoplasty
Left Upper Sleeve Lobectomy
Left Lower Sleeve Lobectomy
Artery Sleeve Resection
Conclusions/Summary
References
Minimally Invasive Thoracoscopic Surgery—Anatomical Segment Resections
Introduction
Indications
Contraindications
Anatomy
Nomenclature of the Segmental and Subsegmental Bronchi
The Right Lung
The Left Lung
Nomenclature of Segmental and Subsegmental Arteries
The Right Lung
The Left Lung
Nomenclature of Segmental and Subsegmental Veins
Surgical Technique
Postoperative Complications
Conclusion
References
Subxiphoid Approach for Anatomical Lung Resections and Lobectomies
Introduction
Patient Selection
Operation Set Up
Instrumentation
Incision
Surgical Steps
Wound Closure and Drainage
Outcomes
Bibliography
Minimally Invasive Pulmonary Resections Techniques—Nonanatomical Pulmonary Resections
Introduction
Non-anatomic Pulmonary Resections for Lung Cancer
Technical Aspects
Oncological Aspects
Conclusions
References
Pulmonary Resections in the Extensive Pulmonary Pathology
Introduction
Chest Wall
Superior Vena Cava
Diaphragm
Left Atrium
Aorta
Vertebrae
Conclusions
References
Techniques for Pulmonary Metastasectomy
Introduction
Electrocautery
Laser
Ligasure
Ultrasicion (Harmonic)
Thermal Sealing with Saline
Alternative Local Treatments for Pulmonary Metastasis Image-Guided Ablative Therapies
Radiofrequency Ablation (RFA)
Microwave Ablation (MWA)
Cryoablation (Cryotherapy)
Sterotactic Radiosurgery (Cyberknife)
Open or Minimal Invasive Methods
References
Approaches in Robot-Assisted Thoracic Surgery (RATS)
Introduction
Robotic Programme Development
Staff Considerations
Theatre Layout
Robot Targeting
Robotic Instruments
Patient Positioning and Port Placement
Patient Positioning and Port Placement for Approach to the Hemithorax
Approach to Right Hemi-thorax
Patient Position
Port Placement
Approach to the Left Hemi-thorax
Patient Position
Port Placement
Patient Positioning and Port Placement for Approach to the Mediastinum
Patient Positioning
Port Placement for a Left Sided Approach to the Mediastinum
The Future
References
The Pleura
Embryology and Anatomy of the Pleura
Embryology
Pleural Histology
Topography of the Pleura
Vascularization of the Pleura
Pleura Innervation
Surgical Considerations on Anatomy of the Pleura
References
Classical and Minimally Invasive Approaches and Surgical Techniques for Malignant Pleural Effusions
Definitions
Pathogenesis
Pathophysiology
Variants of Pleural Effusions Associated Cancers
Clinical Picture
Imaging Investigations
Characteristics of the Pleural Fluid
Fluid Cytology Diagnosis
Histopathological Diagnosis
Treatment of Malignant Pleural Effusions
Treatment of Neoplastic Pleural Effusions with Trapped Lung
Prognosis
References
Pleural Empyema
Introduction
Historical Notes
Etiology
Microbiology
Pathogenesis and Staging
Clinical Presentation
Imaging Studies
Blood Analysis
Pleural Fluid Analysis
Treatment
General Instructions
Antibiotics
Thoracentesis
Chest Drainage
Intrapleural Fibrinolytic Therapy
Surgical Management
Thoracostomy and Space-Filling Techniques
References
Chest Tube
Introduction
Chest Tube Sizes and Types
Indications
Pneumothorax
Malignant Pleural Effusions
Complicated Parapneumonic Effusion and Empyema
Haemothorax and Chylothorax
Chest Tube Insertion
Complications
References
Approaches and Surgical Techniques in the Pleural Tumors
Solitary Fibrous Tumors of the Pleura
Pathology
Clinical Findings
Radiology
Treatment
Prognosis
Diffuse Pleural Tumors
Etiology and Epidemiology
Clinical Features
Radiological Findings
Diagnosis
Staging
Extrapleural Pneumonectomy
Pleurectomy/decortication
Multimodal Treatment
Conclusion
References
Intraoperative Accidents and Postoperative Complications in the Surgery of Pleural Tumours
Introduction
Intraoperative Accidents and Postoperative Complications
Operative Site Complications
Technical Issues
Systemic Complications
Cardiac Complications
Pulmonary Complications
Other System Complications
Outcomes of EPP and P/D
Conclusions/Summary
References
The Mediastinum
Surgical Anatomy of the Mediastinum
Introduction
Classifications
The Thymus
Embrology
Surgical Anatomy
Nervous System
Phrenic Nerves
Vagus Nerves
Thoracic Spinal Nerves
Sympathetic Trunks and Ganglia
Great Vessels Anatomy
Superior Vena Cava and Innominate Veins
Thoracic Aorta and Its Branches
Summary
References
Generalities of the Transcervical Approach to the Mediastinum
Historical Notes
Description of the Exploration: Equipment Required
Intraoperative Monitoring
Positioning and Draping of the Patient
Cervical Incision
Indications of the Transcervical Approach to the Mediastinum
Technical Variants of the Transcervical Approach to the Mediastinum
Contraindications
Complications of the Transcervical Approach to the Mediastinum
References
Approaches and Surgical Techniques in the Thymus Pathology
Introduction
Standard Trans-sternal Thymectomy
Surgical Technique
Transcervical Thymectomy
VATS Thymectomy
RATS Thymectomy
Minimally Invasive Versus Open Approach: General Considerations
References
Approaches and Surgical Techniques for Anterior Mediastinal Pathology
Introduction
Thymic Malignancies
Lymphomas
Endocrine Lesions
Germ Cell Tumours
Benign Thymic Lesions
Bibliography
Approaches and Surgical Techniques in the Visceral Mediastinal Pathology
Introduction
Diagnostics of the Mediastinal Tumors
Operative Procedures
Mediastinoscopy
Anterior Mediastinotomy
Video-Thoracoscopy/Video-Assisted Thoracic Surgery (VATS)
VAMLA
Transcervical Entended Mediastinostinal Lymphadenectomy (TEMLA)
Surgical Technique of TEMLA
Treatment of the Mediastinal Tumors
Minimally Invasive Techniques
Transcervical Approach
Tumors of the Superior Middle Mediastinum
Tumors of the Superior Middle Mediastinum Located in the Aortopulmonary Window Area
VATS
Subxiphoid/Subcostal Approach
Open Surgical Approach
Tumors of the Middle Mediastinum
Thyroid Tumors
Lymphomas
Mediastinal Cysts
References
Approaches and Surgical Techniques for Costovertebral Sulcus Pathology
The Nervous Vegetative System Pathology
Neurogenic Tumors
Introductions
Preoperative Evaluation
Surgical Approaches and Techniques
References
Approaches and Surgical Techniques for Superior Vena Cava Syndrome
Introduction
Anatomy and Pathophysiology
Etiology
Malignant Causes
Clinical Evaluation
Pre-operative Assessment
Diagnosis
Medical Management
Surgical Management
Conclusion/Summary
References
Approaches and Surgical Techniques for Mediastinal Infectious Diseases
Introduction
Surgical Considerations
Clinical Presentation
Diagnosis
Post-sternotomy Mediastinitis
Diagnosis
Surgical Management
Descending Necrotizing Mediastinitis
Surgical Management
Mediastinitis After Oesophageal Perforation
Surgical Management
Chronic Mediastinitis
Management
Conclusion/Summary
References
Minimally Invasive Thymectomy
Introduction
Thymectomy for Myasthenia Gravis
Thymectomy for Thymic Tumours
Mini-sternotomy
Lateral Intercostal Access
Transcervical Access
Subxiphoid Access
Summary
References
Mediastinal Pseudotumours
Definitions
Intrathoracic Goiters
Cystic Lymphangioma (Hygroma)
Lesions of Thoracic Cage
Lesions of Thoracic Spinal Cord
Intrathoracic Extramedullary Hematopoiesis
Vascular Masses of Mediastinum
Arterial Aneurysms
Left Ventricular Aneurysm
Venous Aneurysms
Esophageal Lesions
Lung Lesions
Diaphragmatic Lesions
Hydatic Cyst of the Diaphragm
Congenital Diaphragmatic Cysts
Diaphragmatic Tumors
Subdiaphragmatic Lesions
References
The Pericardium
Embryology and Anatomy of the Pericardium
Introduction
Embryological Development of Pericardium
Formation of the Human Body Cavities
Thoracic Cavity
Anatomical Structure of Pericardium
Fibrous Pericardium
Serous Pericardium
Pericardial Sinuses and Reflections
Clinical Importance of the Transverse Pericardial Sinus
Blood Supply and Innervation of the Pericardium
Functions of the Pericardium
References
Constrictive Pericarditis
Abbreviations
Introduction
Clinic and Diagnosis
Medical Treatment
Surgical Approach
Cardiopulmonary Bypass
Incision
Extend of Pericardiectomy
The Operation
Postoperative Management
Outcomes
Conclusion
References
Malignant Pericardial Effusions
Definitions
Etiopathology—Short Uptodate
Physiopathology—Short Uptodate
Surgical Approaches
Pericardiocentesis (Percutaneous Pericardial Drainage)
Percutaneous Balloon Pericardiotomy
Subxiphoidal Pericardiotomy (Subxiphoidal Open Surgical Drainage)
Left Paraxiphoidian Approach (Left Paraxiphoidian Open Surgical Drainage) (Cezar Motaș Procedure) [21]
Subxiphoid/Paraxiphoid Fenestration with Pericardoscopy
Pleural—Pericardial Window
Peritoneal—Pericardial Window
Pericardiectomy
Prognosis
References
Inflammatory Pericardial Effusion
Introduction
Clinical Presentation
Etiology
Treatment Strategies
Pericardial Drainage
Pericardial Window
Pericardiectomy
Conclusion
References
Pericardial Tumors
Introduction
General
Anatomy and Hystology
Diagnosis
Primary Pericardial Tumors
Benign Pericardial Tumors
Pericardial Cyst
Lipoma
Teratoma
Hemangioma
Paraganglioma
Malignant Pericardial Tumors
Mesothelioma
Sarcoma
Lymphoma
Secondary Pericardial Tumors
References
Intraoperative Accidents and Postoperative Complications in the Surgery of the Pericardium
Abbreviations
Introduction
Problems Possible to Encounter During Surgery
Injuries and Massive Bleeding
Pulmonary Congestion
Hemodynamic Instability
Post Operative Complications
Conclusion
References
The Diaphgram
Anatomy and Embryology of the Diaphragm
Introduction
Anatomy
Blood Supply
Innervation
Surgical Considerations
Embryology
Creation of Thoracic and Abdominal Body Cavities
Embryological Origins of the Diaphragm
Clinical Correlation: Congenital Diaphragmatic Hernia
References
General Aspects in the Pathology of the Diaphragm
Introduction
Diaphragm Paralysis
Unilateral Diaphragm Paralysis
Bilateral Diaphragm Paralysis
Diaphragm Eventration
Diaphragm Hernias
Congenital Diaphragm Hernias
Bochdalek Hernia
Morgagni Hernia
Acquired Diaphragm Hernias
Hiatal Hernia
Diaphragm Tumors
Primary and Secondary Benign Diaphragm Tumors
Primary and Secondary Malignant Diaphragm Tumors
References
Diaphragmatic Hernias
Introduction
Surgical Anatomy
Structure
Arterial and Venous Anatomy
Innervation
Pathologies
Diaphragmatic Elevation
Categorization of Diaphragmatic Hernias
Development of Congenital Diaphragmatic Hernias
Porous Diaphragm Syndrome
Phrenotomy
Plication
Principles of Repair
Plication Techniques
Positioning and Approaches
Congenital Hernia Repairs
Considerations of Repair
Positioning and Airway
Approach
Minimally Invasive Repairs
Hernia Sac Excision
Mesh
Conclusion
References
Approaches and Surgical Techniques in the Acquired Pathology of the Diaphragm
Introduction
Diaphragmatic Relaxation
Candidates for Surgery
Surgical Management
Postoperative Management
Diaphragmatic Tumors
Hiatal Hernia
Esophageal Hiatal Orifice Anatomy
Risk Factors
Symptoms
Diagnosis
Endoscopy
Barium Swallow
Manometry and Reflux Monitoring
Classification
Candidates for Surgery
Surgical Strategy
Anesthesia and Positioning
Collis-Belsey Transthoracic Fundoplication Gastroplasty
Postoperative Management
Conclusion
References
Management of Diaphragmatic Injuries
Introduction
Physiology of the Diaphragm
Pathophysiology of Diaphragmatic Injury
Incidence and Injury Location
Mechanisms of Injury
Associated Injuries
Clinical Presentation
Diagnosis and Imaging Studies
Surgical Management of Diaphragmatic Injuries
Morbidity and Mortality
References
Post-traumatic Diaphragmatic Hernias
Introduction
Anatomy
Embryologic Development
Mechanism and Location of Injury
Clinical Presentation
Diagnosis and Imaging Studies
Delayed Diagnosis and Missed TDI
Surgical Management
Special Situations
Strangulated Diaphragmatic Hernias
Acute Intrapericardial Herniations
References
The Thoracoabdominal Border
Bronchobiliary Fistula
Introduction
Etiology
Pathophysiology
Clinical Findings
Diagnosis
Treatment
Congenital Bronchobiliary Fistula
Conclusion
References
Subphrenic Abscess
Introduction
Subphrenic Space
Etiology
Clinical Findings
Diagnosis
Separation of Subphrenic Abscess from Pleural Effusion
Treatment
Prognosis
Conclusion
References
Carcinoma of the Upper Pole of the Stomach and Gastroesophageal Junction
Introduction
Classification and Staging of Carcinoma of the EGJ
Consensus of Surgical Procedures
Distance from the EGJ to the Edge of the Carcinoma
Abdominal and Transhiatal Approach
Transthoracic and Abdominal Approach
Minimally Invasive Approach
Summary
References
Approaches and Surgical Techniques for Esophageal Achalasia, Hiatal Hernia and GERD (Gastro-Esophageal Reflux Disease)
Introduction
Achalasia
The Surgical Approach: The Cardiomyotomy (Heller)
The Thoracic Approach: Is There Still an Indication?
Alternative Procedures and Evaluation/Comments
Hiatus Hernia
GERD
Operation Technique—Fundoplication
Conclusions/Summary
References
Approaches and Surgical Techniques for Hydatid Cyst of the Dome of the Liver
Introduction
Disease Formation and Life Cycle
Clinical Findings
Laboratory and Serological Tests
Imaging
Treatment
Medical Treatment
Percutaneous Treatment
PAIR
Catheter Treatment
Modified Catheterization Treatment
Surgical Treatment
Transthoracic Approach to Hydatid Cysts in the Liver Dome
Laparoscopic Approach
Result
References
Approaches and Surgical Techniques for Retrocostoxiphoid Hernias
Definitions
Treatment
References
Intraoperative Accidents and Postoperative Complications in the Thoracoabdominal Pathology
General Considerations/Introduction
Diaphragm
Esophagus/Stomach
Chylothorax
Summary
References
Anterior/Posterior Thoracoabdominal Approaches
Introduction
History
Indications
Anesthesia Management
Operative Techniques
Patient Positioning
Thoracotomy Techniques
Diaphragm Incision
Laparotomy Techniques
Wound Closure
Modifications
Complications
References
Thoracotomy as the Surgical Route for Synchronous Thoracic and Non-thoracic Procedures
Introduction
Diaphragm
Adrenal Glands and Kidney
Liver
Esophagus and Stomach
Lung
Traumatic Injuries, Spleen, Pancreas and Diaphragm
Thoracoabdominal Incision
References
One Stage Minimally Invasive Thoracoscopic Lung Resection and Transphrenic Adrenalectomy: Surgical Technique
References
Anterior Surgical Approach to the Abdominal Aorta
Introduction and Anatomy
Preoperative and Preanaesthetic Considerations
Transperitoneal Approaches
Median Laparotomy
Chevron
Extended Incisions: Xifoidectomy, Partial Median Sternotomy
Transverse Laparotomy or Horizontal Transperitoneal Approach
Manoeuvres
Longitudinal Inframesocolic Access
Supramesocolic Access
Supraceliac Clamping
Medial Visceral Rotation
Left (Mattox Manoeuvre): Retrorenal and Prerenal
Right (Cattell Braasch Manoeuvre). Kocher Manoeuvre
Summary
Bibliography
Lung Transplantation
Extended Criteria and Donation After Circulatory Determined Death (DCD) Donors for Lung Transplantation
Extended Criteria Donors
Age
Smoking
Smoking of Cannabis and Cocaine
Suicidal Hanging Donors
Donor Malignancy
Arterial Blood Gases
Radiology
Infections
Extended Criteria Donors and Lung Donor Scoring Tools
Donation After Circulatory Death
Warm Ischaemic Time
Ex-Vivo Lung Perfusion (EVLP)
Techniques of Ex-Vivo Lung Perfusion
Organ Care System (OCS) for Lung
Outcomes for Lung Transplant Recipients Using Ex-Vivo Lung Perfusion
Outcomes for DCD Versus DBD Lung Transplantation
Increase in Lung Donation from DCD Donors
Conclusion
References
Bridge to Lung Transplantation
Abbreviations
Introduction
“Bridging” to Transplant
Patient Characteristics
Modalities of ECLS and Technical Specificities
PECLA (Pumpless Extracorporeal Lung Assist)
Veno-venous ECMO
Veno-arterial ECMO
“Awake ECMO”—Walking While Waiting
Limitations and Complications
Clinical Evidence
Conclusion
References
Indications and Contraindications in Lung Transplantation
Abbreviations
Indications for Lung Transplantation
Disease Specific Considerations
Interstitial Lung Disease
Cystic Fibrosis
Emphysema (COPD and Alpha-1 Antitrypsin Deficiency)
Pulmonary Vascular Diseases
Absolute Contraindications
Malignancy
Organ Failure
Compliance
Mental Disorders
Functional Limitations
Substance Abuse
Relative Contraindications
Age
BMI
Frailty
Coronary Artery Disease
Obesity
Other Medical Conditions
Bacterial/Fungal Infection
HIV/Hepatitis
Chest Wall Deformities
Other Conditions
Surgical Considerations
Pneumonectomy
Lung Volume Reduction Surgery (LVRS) and Endoscopic Lung Volume Reduction (ELVR)
Extracorporeal Life Support (ECLS)
Re-transplantation
Conclusion
References
Approaches and Surgical Techniques in Lung Transplantation
Introduction
Approaches to the Chest for Lung Transplantation
Anatomical Principles of Lung Transplantation
Explant
Implant
Off-Pump
Using Cardiopulmonary Bypass
Pitfalls of Cardiopulmonary Bypass
Use of Venoarterial Extracorporeal Membrane Oxygenation (VA ECMO)
Decision Making in Choice of Incision and Extracorporeal Support
Conclusions
References
Anesthesia in Lung Transplantation ,
Introduction (with Definitions)
Preoperative Assessment, Investigations and Monitoring
Anesthetics
Hemodynamic Agents
Ventilation Techniques Depending on Lung Disease
Primary Graft Dysfunction
Differential Diagnosis of Intraoperative Hypoxia During Lung Transplantation
Types of ECMO Used
Echocardiography
Summary and Conclusions
References
Postoperative Complications and Management
Introduction
Primary Graft Dysfunction
Epidemiology
Outcomes
Pathophysiology and Risk Factors
Treatment
Cannulation Strategies
Retransplantation
Airway Complications
Pleural Complications
Neurological Complications
Gastrointestinal Complications
Cardiovascular Complications
Atrial Arrhythmias
Right Ventricular Dysfunction
Renal Complications
Infections
Recipient Derived Infections
Donor Derived Infection
Antimicrobial Prophylaxis
Multi-drug Resistant (MDR) Organisms
Fungal Infection
Viral Infections
Other Viruses
Mycobacteria
Acute Rejection
Chronic Lung Allograft Dysfunction
Malignancy
Other Complications, Immunosuppressant Drugs and Pharmacotherapy
References
Size Matching in Lung Transplantation
Abbreviations
Introduction
Markers Used for Size Matching
Complications of Inappropriate Size Matching
Size Matching in Single Lung Transplantation
Size Matching in Bilateral Lung Transplantation
Transplant Size Matching in Restrictive Lung Disease
Size Matching in Living Lobar Lung Transplantation (LDLLT)
Multiple-Choice Questions About Size Matching in Lung Transplantation
References
Lobar Transplantation
Cadaveric Lobar Lung Transplantation
Anatomic Size Matching Between Donor and Recipient
Surgical Technique
Oversized and Undersized Graft
Conclusion
Living Donor Lobar Lung Transplantation
Patient Selection
Conclusion
References
Lung Retransplantation
Glossary
References
Single Versus Bilateral Lung Transplantation
Introduction
Post-transplant Survival
Post-transplant Lung Function
Post-transplant and Quality of Life and Functionality
Allograft Rejection
Economic and Societal Effects
Unique Situations
Summary
References
The Role of Ex-vivo Lung Perfusion (EVLP) in Lung Transplantation
Introduction
History of EVLP
Rationale for EVLP and Indications for Its Use
EVLP to Expand the Donor Pool
EVLP Circuit
EVLP Technique
EVLP Protocols
The Lund Protocol
The Toronto Protocol
The OCSTM Protocol (TransMedics FDA Protocol)
EVLP to Optimize Organ Allocation
EVLP to Improve Allograft Function
Conclusion
References
ECMO Support in Lung Transplantation
Introduction
Indications
Surgical/Technical Considerations
ECMO as a Bridge to Lung Transplantation
ECMO as Replacement for Cardiopulmonary Bypass
ECMO and Post-lung Transplantation
Conclusion
References
Extracorporeal Lung Assist Devices
Introduction
Evolution of ECLS (Fig. )
ECMO as a Lung Assist Device
General Principles
ECMO Circuitry
Parts of the Circuit
Use of ECMO as a lung assist device
ECCOR as a Lung Assist Device
General Principles
Modern VV-ECCOR (Low Flow Technique)
Clinical Uses of ECCOR
ECCOR in ARDS
Other Clinical Uses of ECCOR
Other Lung Assist Devices
Conclusion
References
Surgery for Chronic Thromboembolism Affecting the Lungs
Pulmonary Endarterectomy
Abbreviations
Introduction to Chronic Thromboembolic Pulmonary Hypertension
Incidence
Risk Factors
Clinical Presentation
Diagnosis
Management
Patient Selection for Pulmonary Endarterectomy
Surgical Technique
Post-operative Management
Outcomes
Conclusion
References
Thoracic Trauma
Thoracic Traumas—General Aspects
Introduction
Primary Survey
Airway with Cervical Spine Control
Breathing and Ventilation
Circulation and Haemorrhage Control
Disability and Neurologic Assessment
Exposure/Environmental Control
Emergency Department Interventions
Pneumothorax
Haemothorax
Cardiac Tamponade
Emergency Room Thoracotomy
Secondary Survey
Blunt Trauma
Tracheobronchial Injuries
Pulmonary Contusion
Blunt Cardiac Injury
Traumatic Aortic Disruption
Rib Fractures and Flail Chest
Sternal Fractures
Diaphragmatic Injuries
Traumatic Asphyxia
Penetrating Trauma
Chest Wall Injuries
Lung Injuries
Tracheobronchial Injuries
Heart and Major Vessels Injuries
Oesophageal Injuries
Conclusions
References
Blunt Thoracic Traumas
Introduction
Pleural Injuries
Haemothorax
Pneumothorax
Lung Injuries
Pulmonary Contusion
Pulmonary Lacerations
Tracheobronchial Injuries
Chest Wall Injuries
Rib Fractures and Flail Chest
Sternal Fractures
Diaphragmatic Injuries
Oesophageal Injuries
Conclusions
References
Open Thoracic Trauma
Definitions
Non-penetrating Open Thoracic Trauma
Penetrating Open Thoracic Trauma
Bibliography
Damage-Control Thoracic Surgery
Introduction
Damage-Control Thoracotomy
Operating Room
Cardiac Injury
Intrathoracic Vascular Injury
Lung Injury
Tracheobronchial Injury
Esophageal Injury
Temporary Thoracic Closure
Postoperative Care in the Intensive Care Unit
References
Approaches and Surgical Techniques for Chest Wall Trauma
Introduction
Historical Perspective
Modern Treatment Strategies
Non-operative Management
Mechanical Ventilation
Pain Control
Respiratory Therapy
Indications for Surgical Management
Surgical Approaches
Chest Wall Stabilization
Conclusions
References
Index