Current Controversies in Thoracic Surgery, An Issue of Thoracic Surgery Clinics of North America,

Name: Current Controversies in Thoracic Surgery, An Issue of Thoracic Surgery Clinics of North America, | Current Controversies in Thoracic Surgery, an Issue of Thoracic Surgery Clinics of North America, E-Book
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Current Controversies in Thoracic Surgery, an Issue of Thoracic Surgery Clinics of North America, E-Book

Michael Lanuti(Autor*in)

Elsevier (Verlag)

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Erschienen am 26. Juli 2016

100 Seiten

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Front Cover
Current Controversies in Thoracic Surgery
Copyright
Contributors
CONSULTING EDITOR
EDITOR
AUTHORS
Contents
Preface: Managing Controversial Issues in Thoracic Surgery
Mediastinal Staging: Endosonographic Ultrasound Lymph Node Biopsy or Mediastinoscopy
Sublobar Resection: Ongoing Controversy for Treatment for Stage I Non-Small Cell Lung Cancer
Stereotactic Body Radiation Therapy for Stage I Non-Small Cell Lung Cancer
Management of Stage IIIA (N2) Non-Small Cell Lung Cancer
Surgical Management of Oligometastatic Non-Small Cell Lung Cancer
The Role of Induction Therapy for Esophageal Cancer
The Evolution and Current Utility of Esophageal Stent Placement for the Treatment of Acute Esophageal Perforation
Lymph Node Dissection and Pulmonary Metastasectomy
Induction Therapy for Thymoma
Best Approach and Benefit of Plication for Paralyzed Diaphragm
Video-Assisted Thoracic Sympathectomy for Hyperhidrosis
Current Treatment of Mesothelioma: Extrapleural Pneumonectomy Versus Pleurectomy/Decortication
THORACIC SURGERY CLINICS
FORTHCOMING ISSUES
November 2016
February 2017
May 2017
RECENT ISSUES
May 2016
February 2016
November 2015
Preface: Managing Controversial Issues in Thoracic Surgery
Mediastinal Staging
Key points
INTRODUCTION
WHY DO WE STAGE IN NON-SMALL CELL LUNG CANCER?
IN WHOM DO WE INVASIVELY STAGE THE MEDIASTINUM IN NON-SMALL CELL LUNG CANCER?
WHO DOES NOT NEED INVASIVE MEDIASTINAL STAGING IN NON-SMALL CELL LUNG CANCER?
WHAT IS AN IDEAL GOLD STANDARD TEST IN STAGING LUNG CANCER?
ENDOSONOGRAPHIC ULTRASOUND (COMBINED ENDOBRONCHIAL ULTRASOUND-ENDOSCOPIC ULTRASOUND), LYMPH NODE BIOPSY, OR MEDIASTINOSCOPY?
Lymph Node Access, Sensitivity, Accuracy, and Negative Predictive Value
Complication Rate
Cost
Restaging After Neoadjuvant Chemoradiation
Aortopulmonary Window Lymph Nodes
SUMMARY
REFERENCES
Sublobar Resection
Key points
HISTORY
PROSPECTIVE RANDOMIZED TRIALS
POPULATION-BASED ANALYSIS
RETROSPECTIVE ANALYSIS
FACTORS EFFECTING OUTCOME
Tumor Size
Surgical Margin
Segmentectomy
SPECIAL CONSIDERATIONS
The Elderly Patient
Ground Glass Nodules
SUMMARY
REFERENCES
Stereotactic Body Radiation Therapy for Stage I Non-Small Cell Lung Cancer
Key points
INTRODUCTION
MEDICALLY INOPERABLE PATIENTS
Development of Stereotactic Body Radiation Therapy Technique
Prospective Collaborative Trials
MEDICALLY OPERABLE PATIENTS
Retrospective Experience
Prospective Phase II Trials
Randomized Phase III Trials
Large Database Analyses
TOXICITY CONSIDERATIONS WITH STEREOTACTIC BODY RADIATION THERAPY
Skin and Chest Wall/Rib
Central Location
Pulmonary Toxicity
OPTIMAL STEREOTACTIC BODY RADIATION THERAPY DOSE
SUMMARY
REFERENCES
Management of Stage IIIA (N2) Non-Small Cell Lung Cancer
Key points
BACKGROUND
STAGING CONSIDERATIONS
Accurate Determination of IIIA (N2) Non-Small Cell Lung Cancer
Initial Staging
How Do Endobronchial Ultrasound and Mediastinoscopy Compare?
Occult N2 Disease
Is Restaging Necessary After Neoadjuvant Therapy?
Who Can Tolerate a Multimodality Treatment Regimen?
THE EVOLUTION OF MULTIMODALITY TREATMENT FOR LOCALLY ADVANCED LUNG CANCER
Radiation Dosage in the Neoadjuvant Setting
Phase II Trials of Neoadjuvant Concurrent Chemoradiation
Intergroup 0139-Definitive or Just Old News?
EVOLUTION OF TREATMENT IN THE MODERN ERA: INTERGROUP 0139 AFTERMATH
The Role of Surgery
Who Should be Considered for Surgery: Not All N2 Is Created Equally
Is Surgery Safe After Neoadjuvant Chemoradiation to 60 Gy?
Outcomes of Surgery for Stage IIIA (N2)
Specific Surgical Considerations
Persistent N2 disease
Incidentally discovered N2
Is a pneumonectomy really too dangerous to be considered after radiation therapy?
Unresolved Issues in Treating IIIA (N2) Disease: Chemotherapy
Adjuvant versus neoadjuvant prescription
Major studies evaluating adjuvant chemotherapy
Adjuvant chemotherapy for patients who have received neoadjuvant therapy
Targeted therapy in IIIA (N2) regimens
UNRESOLVED ISSUES: RADIATION
Neoadjuvant Radiation Dose
More Is Not Always Better
Is Neoadjuvant Radiation the Right Paradigm to Follow?
Revisiting Postoperative Radiation Therapy
Evolving Radiation Therapy
THE FUTURE---MORE COMPLICATED, NOT LESS
Proton Beam Therapy
Immunotherapy
Targeted Therapy
SUMMARY
Evidence-based Treatment Regimens for Potentially Resectable IIIA (N2) Disease
What Can Be Said Definitively from the Literature?
Ongoing Challenges in Studying Stage IIIA (N2) Disease
Final Statement
REFERENCES
Surgical Management of Oligometastatic Non-Small Cell Lung Cancer
Key points
INTRODUCTION
DEFINITION OF OLIGOMETASTATIC DISEASE
PRINCIPLES OF SURGICAL TREATMENT
ORGAN-SPECIFIC CONSIDERATIONS
Solitary Brain Metastasis
Solitary Adrenal Metastases
Other Organs
OUTCOMES
SUMMARY
REFERENCES
The Role of Induction Therapy for Esophageal Cancer
Key points
INTRODUCTION
ROLE OF INDUCTION THERAPY
Induction Chemotherapy
Induction Chemoradiation
Induction Chemotherapy Versus Induction Chemoradiation
SELECTING THERAPY
SUMMARY
REFERENCES
The Evolution and Current Utility of Esophageal Stent Placement for the Treatment of Acute Esophageal Perforation
Key points
INTRODUCTION
HISTORY
EARLY IMPLEMENTATION
CURRENT STATE
Exclusion Criteria
Stent Placement Technique
Outcomes
REFERENCES
Lymph Node Dissection and Pulmonary Metastasectomy
Key points
INTRODUCTION
INTRATHORACIC LYMPH NODE INVOLVEMENT AND ISOLATED PULMONARY METASTASIS BY PRIMARY TUMOR HISTOLOGY
Colorectal Carcinoma
Renal Cell Carcinoma
Sarcoma
Germ Cell Tumors
Melanoma
Head and Neck Squamous Cell Carcinoma
Breast Carcinoma
Incidence and Prognostic Value of Nodal Status by Histology
DOES N1 VERSUS N2 LYMPH NODE DISEASE MATTER?
DOES MEDIASTINAL LYMPHADENECTOMY IMPROVE SURVIVAL?
WHICH PATIENTS SHOULD UNDERGO MEDIASTINAL LYMPH NODE DISSECTION?
REFERENCES
Induction Therapy for Thymoma
Key points
INTRODUCTION
GENERAL APPROACH TO THE TREATMENT OF LOCALLY ADVANCED THYMIC TUMORS
INDUCTION CHEMOTHERAPY IN THYMOMA
INDUCTION CHEMORADIATION IN THYMOMA
INDUCTION RADIATION IN THYMOMA
SPECIAL CONSIDERATIONS WITH STAGE IVA DISEASE
ROLE OF TARGETED THERAPIES
WHAT IS THE ACTUAL BENEFIT OF INDUCTION THERAPY?
REFERENCES
Best Approach and Benefit of Plication for Paralyzed Diaphragm
Key points
INTRODUCTION
Diaphragmatic Eventration and Diaphragmatic Paralysis
PATHOPHYSIOLOGY AND CLINICAL PRESENTATION
DIAGNOSIS AND PREOPERATIVE EVALUATION
Symptom Evaluation
Objective Respiratory and Quality of Life Evaluation
Physical Examination
Pulmonary Function Tests
Imaging Studies
Chest radiograph
Fluoroscopic sniff test
Ultrasound
Computerized tomography
Other Diagnostic Tests
SURGICAL TREATMENT
Diaphragmatic Plication
Indications
Contraindications
Surgical Approaches
Open transthoracic plication
Thoracoscopic video-assisted thoracoscopic surgery and robotic-assisted plication
Open transabdominal plication
Laparoscopic plication
Laparoscopic Diaphragm Plication Surgical Technique
Anesthesia
Position
Ports
Suture material
Procedure steps
Exposure
Controlled pneumothorax
Posterior plication
Anterior plication
Tube thoracostomy
Lung reexpansion
Postoperative care
Complications of diaphragm plication
REHABILITATION AND RECOVERY
Comparison of Surgical Approaches for Diaphragm Plication
SUMMARY
REFERENCES
Video-Assisted Thoracic Sympathectomy for Hyperhidrosis
Key points
INTRODUCTION
PRIMARY OR IDIOPATHIC HYPERHIDROSIS
Palmar Hyperhidrosis
Plantar Hyperhidrosis
Axillary Hyperhidrosis
Cranial-Facial Hyperhidrosis
THORACIC SYMPATHECTOMY
General Anesthesia
Positioning
Instruments
Technique
TARGET GANGLIA
Palmar Hyperhidrosis
Axillary Hyperhidrosis
Cranial-facial Hyperhidrosis and/or Flushing
Plantar Hyperhidrosis
ALTERNATIVES TO SYMPATHECTOMY
CLINICAL TREATMENT WITH OXIBUTININ
QUALITY OF LIFE VERSUS PRIMARY HYPERHIDROSIS
RESULTS OF VIDEO-ASSISTED THORACIC SYMPATHECTOMY
DIFFICULTIES AND TECHNICAL COMPLICATIONS
Pleural Adherences
The Azygous Lobe
Significant Hemorrhage
Chylothorax
Pneumothorax
Subcutaneous Emphysema
Pulmonary Atelectasis
Transitory Brachycardia
Postoperative Pain
Paresis and Paresthesia
Horner Syndrome
Contraindications
REASONS FOR VIDEO-ASSISTED THORACIC SYMPATHECTOMY FAILURE
Incomplete Surgery
Regeneration
Functional Reorganization
REFERENCES
Current Treatment of Mesothelioma
Key points
INTRODUCTION
THE CASE FOR SURGERY IN TREATMENT OF MALIGNANT PLEURAL MESOTHELIOMA
OPTIONS FOR SURGERY
Extrapleural Pneumonectomy
Preoperative evaluation for extrapleural pneumonectomy
Extrapleural pneumonectomy perioperative management
Extrapleural pneumonectomy surgical technique
Extrapleural pneumonectomy postoperative care
Extrapleural pneumonectomy results
Pleurectomy Decortication
Pleurectomy decortication preoperative evaluation
Pleurectomy decortication perioperative management
Pleurectomy decortication surgical technique
Pleurectomy decortication postoperative care
Pleurectomy decortication results
DATA COMPARING EXTRAPLEURAL PNEUMONECTOMY WITH PLEURECTOMY DECORTICATION
SUMMARY
REFERENCES
Index

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