Surgical Adjuncts During Esophagectomy
Esophagectomy is a major operation whereby intraoperative technique and postoperative care must be optimal. Even in expert hands, the complication rate is as high as 59%. Here the authors discuss…
CARDIAC SURGERY
Prevention of Postoperative Prolonged Air Leak After Pulmonary Resection
Postoperative prolonged air leaks (PALs) occur after thoracic surgery in which lung parenchyma is resected, divided, or manipulated. These air leaks can place patients at risk for intensive care unit…
Management of Complications After Esophagectomy
Esophagectomy is a complex operation with many potential complications. Early recognition of postoperative complications allows for the best chance for patient survival. Diagnosis and management of conduit complications, including leak,…
Open, Minimally Invasive, and Robotic Approaches for Esophagectomy
Esophageal cancer requires a multimodality treatment approach, with surgical resection a key component in many cases. When it comes to esophagectomy, several approaches and techniques exist, including transhiatal versus transthoracic…
Intraoperative Anesthetic Management of the Thoracic Patient
The intraoperative anesthetic management for thoracic surgery can impact a patient’s postoperative course, especially in patients with significant lung disease. One-lung ventilation poses an inherent risk to patients, including hypoxemia,…
Enhanced Recovery After Thoracic Surgery
Enhanced recovery pathways (ERPs), used across multiple surgical subspecialties, is a multidisciplinary delivery of perioperative care designed to lessen the psychological stress of patients undergoing surgery. Thoracic ERP has been…
Prehabilitation of the Thoracic Surgery Patient
Outcomes after thoracic surgery are better predicted by preoperative evaluation of patients’ physiologic reserve (also known as personal biologic age rather than chronologic age), using validated assessment tools in multidisciplinary…
Preoperative Evaluation for Thoracic Surgery
Preoperative evaluation before thoracic surgery aims to separate those patients who will tolerate surgery and those who are not surgical candidates. Predicted postoperative pulmonary function testing helps make this distinction….
Coronary Artery Anomalies in the Adult
Fig. 20.1 The operation to repair ALCAPA by coronary reimplantation to the ascending aorta is commenced through a median sternotomy. Cardiopulmonary bypass (CPB) techniques and aortic cross-clamping require important considerations…
Fontan, 1½ Ventricular Repair, and Fontan Conversion Operations in Adults
Fig. 11.1 Fig. 11.2 Fig. 11.3 Fig. 11.4 Fig. 11.5 Fig. 11.6 11.1.2 Primary Extracardiac Fontan Operation with Fenestration Constructing a fenestration with an extracardiac conduit requires strategies to avoid…
