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…
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…
Superior Pulmonary Sulcus (Pancoast) Tumors
Figure 46.1 The patient is intubated with a double-lumen tube and placed in a lateral decubitus position. The sterile field is prepared to include the upper arm and scapula, with…
Chest Wall Resection and Repair
Figure 42.1 Excision and margins. In most cases, general anesthesia is accomplished with a single-lumen endotracheal tube. If associated pulmonary resection is anticipated, single-lung anesthesia is best provided by double-lumen…
Resection of Malignant Mediastinal Germ Cell Tumors
Figure 35.1 The basic premise of our surgical approach involves complete en bloc removal of the RM, thymus, and surrounding involved structures. Surgery for PMNSGCT is technically demanding because preoperative…
Lymph Node Dissection
Figure 20.1 Dissection of paratracheal lymph nodes from right thoracotomy. All fatty areolar tissue is dissected from the superior vena cava (SVC), aorta, and trachea. Gentle traction and dissection with…
