Thoracoplasty
1. First cleaning steps by tube, irrigation, etc. Dealing with bronchial stump in case of bronchopleural fistula 2. Débridement 3. Open window 4. Vacuum-assisted closure (VAC) 5. Space filling (a)…
Pulmonary Lobectomy (Thoracotomy and VATS)
Figure 17.1 Standard posterolateral thoracotomy incision. LD latissimus dorsi muscle Right Upper Lobectomy The lung is retracted laterally to place the superior hilar vessels on tension. The mediastinal pleura over…
Pneumothorax
Etiology Clinical appearance Size (British Medical Society) Spontaneous Closed pneumothorax (also called pneumothorax simplex) Small (lung <2 cm from the chest wall) Symptomatic Open pneumothorax Large (lung >2 cm from…
Nuss Procedure for Pectus Excavatum
Figure 45.1 Positioning. The patient is placed in the supine position with both arms abducted at a 10° angle to minimize tension in the cervicothoracic crossing and brachial plexus. The…
Sternal Infection
Figures 50.1 and 50.2 (a–d) The most important step is radical surgical débridement with complete removal of all infected and necrotic material. This step also includes removal of all wires…
Thoracotomy Pneumonectomy
Complication Incidence (%) Atrial arrhythmia 20.2 Reintubation 5.6 Pneumonia 4.6 Adult respiratory distress syndrome 3.1 Tracheostomy 2.5 Ventilator support >48 h 2.1 Sepsis 1.7 Reoperation for bleeding 1.5 Ventricular arrhythmia…
Pleural Empyema
Figure 37.1 After localization of the empyema via needle puncture, a 4 cm skin incision is made, followed by a rib resection of 2–3 cm (Fig. 37.1b). After the chest…
Benign and Malignant Pleural Effusions
Figure 36.1 (a) The patient undergoes general anesthesia and double-lumen intubation and is placed in a stretched lateral decubitus position, secured by a side-positioned cushion and elevated arm support. Bronchoscopy…
Diaphragm Plication and Repair
Figure 47.1 Open transthoracic approach. Open transthoracic plication is the traditional approach to treating patients with symptomatic diaphragm eventration or paralysis. Most authors recommend a posterolateral thoracotomy through the sixth…
Superior Vena Cava Resection
Figure 34.1 There are several approaches to surgery of the SVC, the choice of which may depend on the surgeon’s preferences. However, in deciding which one to use, the surgeon…
