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Flashcards in Thoracic Surgery Deck (15)
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What is the main reason for a pneumonectomy?

Almost always because of tumour high up in airways


What position should be avoided for patients with a pneumonectomy?

Removed lung side up
- Fluid in the space, causing it to be heavy, compresses good lung in this position


What incision is used for a pulmonary resections?

Posterolateral thoracotomy - also used in oesophageal & some cardiac surgery


Where is a posterolateral thoractomy incision located?

From anterior axillary line approx 6th-7th IC space, running up past inferior angle of scapula to spinous process


What muscles are cut in a posterolateral thoractomy?

- Trapezius
- Lats
- Serratus anterior


What is an anterolateral incision used for?

- Trauma
- Patients who are CV unstable


Where is an anterolateral incision located & what muscles are cut?

- Submammary from midline anteriorly to mid axillary line
- Pec major/minor, serratus anterior, intercostals


What is a pleurodesis?

Pleural surfaces are irritated so they adhere together


What condition is a pleurodesis used for?

Malignant pleural effusion - patient gets it constantly, pleural space stuck together to decrease occurrence


What does pleurectomy and decortication involve?

Stripping away the pleura if fibrosed or in the presence of malignancy


What is the less invasive procedure used for lung and pleural examination/surgery?

Video assisted thorascopy (VAT)


What post-op outcomes is a PLT associated with?

- Impairment of VC & 6 minute walk test for up to 6 months
- Worse post op pain & reduction in lung function


What did Reeve et al (2010) find in regards to PPCs post thoracotomy?

No difference in PPCs between patients receiving post op physio & patients who just mobilised with medical staff


What did Reeve et al (2010) find in regards to shoulder pain post thoracotomy?

Lower total pain scores in treatment group at 1 & 3 months


What role does physio have for thoracotomy patients?

- Non-standard patients who can't mobilise may need treatment
- Musculoskeletal exercise prescription & advice to reduce shoulder pain & increase function