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Thoracic Surgery Basics
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Segmentectomy
Indications: Early-stage lung cancer, limited pulmonary reserve. Key considerations: Precise anatomical resection, minimization of tissue loss, and preservation of lung function.
Mediastinoscopy
Indications: Evaluation of mediastinal lymph nodes, biopsy for cancer staging. Key considerations: Avoidance of vital structures, including great vessels and nerves; accurate lymph node sampling.
Video-Assisted Thoracoscopic Surgery (VATS)
Indications: Diagnosis and treatment of pleural diseases, lung biopsy, early-stage lung cancer. Key considerations: Minimally invasive approach, intercostal nerve preservation to reduce pain, and rapid postoperative recovery.
Thoracotomy
Indications: Access for various intrathoracic surgeries, such as tumor resection or cardiac surgery. Key considerations: Incision planning, patient positioning, and management of post-op pain.
Lobectomy
Indications: Lung cancer, bronchiectasis, or large benign tumors. Key considerations: Preservation of surrounding lung tissue, ensuring clear margins, and management of lymph nodes.
Pneumonectomy
Indications: Large central lung cancers, extensive disease not amenable to lesser resections. Key considerations: Adequate cardiopulmonary reserve, minimizing post-op complications, and ensuring patient's ability to tolerate loss of lung volume.
Chest Wall Resection
Indications: Malignant chest wall tumors, recurrent breast cancer, radiation necrosis. Key considerations: Maintenance of chest wall stability, reconstruction options, and management of potential pulmonary complications.
Pleurectomy
Indications: Malignant mesothelioma, recurrent pleural effusions for pleurodesis. Key considerations: Palliation of symptoms, careful dissection to minimize bleeding, and management of persistent air leaks.
Esophagectomy
Indications: Esophageal cancer, severe esophageal strictures, or high-grade dysplasia in Barrett's esophagus. Key considerations: Maintenance of GI continuity, nutritional support, and anastomotic technique.
Decortication
Indications: Empyema, chronic pleural effusions, or trapped lung due to pleural thickening. Key considerations: Complete removal of fibrous peel, preservation of lung parenchyma, and prevention of recurrence.
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