Non lung-cancer thoracic surgery Flashcards

1
Q

What other reasons do we perform thoracic surgery for?

A

Lung Abscess
Empyema
Thymic Tumours
Tracheal surgery
Benign Lung Tumours
Pneumothorax/Bullous Lung Disease
Bronchogenic Cysts
Lung Transplant

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2
Q

What are the most common causes of lung Abscess?

A

PNEUMONIA
aspiration
Pulmonary ThromboEmbolism (PTE)
Septic Emboli
Lung Cancer

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3
Q

How can you see a lung abscess on a CXR?

A

visible fluid level.

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4
Q

What are the common causes of empyema?

A

Pneumonia
Post-op
Oesophageal
Osteomyelitis
Post-traumatic

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5
Q

How can an empyema cause a ‘trapped lung’?

A

The pus can cause an inflammatory response in the pleura leading to them thickening, this can prevent lung expansion once the pus is cleared.

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6
Q

How do we treat an empyema?

A

With urgent drainage and IV antibiotics.

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7
Q

How do we treat a ‘trapped’ lung following empyema?

A

Pleurectomy & Decortication.

Basicaly pealing off the pleura to allow the lung to expand again.

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8
Q

What are all thymic tumours removed rapidly regardless of malignancy?

A

To prevent them spreading to sensitive areas like the aortic arch or heart itself.

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9
Q

Name some types of thymic tumour:

A

Thymoma/Thymic Carcinoma
Thymolipoma
Carcinoid tumours
Lymphoma

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10
Q

What kind of tracheal surgery do we do?

A

Repairing iatrogenic injury

Removing salivary gland tumours and squamous carcinoma

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11
Q

What kind of benign lung tumours can arise?

A
Hamartoma
Fibroma
Lipoma
Neural Tumours
Papilloma
Chondroma (cartilaginous)
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12
Q

Why is a recurrent pnemothorax often a haemopneumothorax?

A

Because adhesions from healing the first time are torn the second time leading to blood in the pleural cavity.

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13
Q

What is bullous lung disease?

A

An space of trapped air growing in the lung, can fill the entire hemithorax

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14
Q

What is a persistant pneumothorax?

A

One that fails to drain (i.e. the whole wont seal)

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15
Q

When do we perform surgery on a pneumonthorax?

A

If its recurrent, persistant or the person needs it prevented for a special reason (e.g. military, pilot etc)

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16
Q

What procedures can be done to a pneumothorax?

A

Pleurodhesis (Thoracoscopy to inspect surface of pleura, use medical staples for any tears then spray in talc to adhere the pleura)
Pleurectomy

17
Q

What are bronchogenic cysts?

A

Cysts around the main airways present from birth

They press on the trachea and oesophagus.

18
Q

What are common reasons for a lung transplant?

A

Cystic Fibrosis (need both or the affected lung will cause accelerate failure of the new)
Pulmonary Fibrosis
Emphysema

19
Q

What are contraindicators for a lung transplant?

A
>65 yrs
Overweight (as steroids post-op will cause weight gain)
Diabetic
Renal Failure
Mental Illness