Flashcards in Thoracic Surgery Deck (15):
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?
- Serratus anterior
What is an anterolateral incision used for?
- 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