Difficult Decisions in Thoracic Surgery: An Evidence-Based Approach

Description:

This updated volume provides a practical guide to decision making within thoracic surgery. Focussed chapters contain pithy analyses and recommendations that allow useful information to be identified at a glance. All new chapters bring insight into the challenges faced operating on the lung, esophagus, diaphragm, airway, pleaura, mediastinum, and chest wall. Difficult Decisions in Thoracic Surgery aims to help the reader navigate the complexities of thoracic surgery through clearly formatted and evidence-based chapters. The book is relevant to practicing and trainee surgeons, as well as medical professionals working within thoracic surgery.

Table of Contents:

1. Introduction

2. Evidence Based Medicine: Quality of Evidence and Evaluation Systems

3. Decision Analytic Techniques and Other Decision Processes

4. Decision Making: The Surgeon’s Perspective

5. Involving Patients in Difficult Decisions About Having Surgery

Part I. Lung

6. EBUS vs. Mediastinoscopy for Initial Pathologic Mediastinal Staging in NSCLC

7. Does Preoperative Smoking Cessation Reduce Surgical Morbidity After Lung Resection?

8. Is Low Tech as Good as High Tech Exercise Testing in Assessing Healthy Candidates for Lung Resection?

9. Does Assessment of Frailty and Sarcopenia in Lung Resection Candidates Affect Patient Selection?

10. Can Frailty and Sarcopenia Be Mitigated in Lung Resection Candidates?

11. Is Antibiotic Prophylaxis Necessary for Major Lung Resection?

12. Uniportal Versus Multiportal VATS Lobectomy

13. Robotic Versus Video-Assisted Thoracoscopic Surgery (VATS) Major Lung Resection for Early Stage NSCLC

14. Does Blood Patch for Persistent Postoperative Air Leak Reduce Air Leak Duration

15. Is Resection of Persistent N2 Disease After Induction Therapy Effective?

16. N2 Disease Discovered at the Time of Vats Lung Resection: Resect or Abort?

17. Does Induction Immunotherapy Confer Increased Operative Risk for Lung Resection?

18. Does an Enhanced Recovery Program for Lobectomy Improve Surgical Outcomes?

19. Resection vs. SBRT for Stage I NSCLC in Patients with Good Pulmonary Function

20. Do Endobronchial Valves Assist in Resolution of Postoperative Persistent Air Leak?

21. Is Long-Term Surveillance Effective After Resection of Stage I Non-small Cell Lung Cancer?

22. Does ECMO for Lung Failure in ICU Patients Improve Survival?

23. Does Local Therapy for Oligometastatic Disease in Lung Cancer Patients Improve Survival?

24. Is Pulmonary Metastasectomy Effective in Prolonging Survival?

Part II. Esophagus

25. Surgical Resection Versus Endoscopic Therapy for T1bN0 Esophageal Adenocarcinoma

26. Does Induction Therapy for T2N0 Esophageal Adenocarcinoma Patients Improve Survival?

27. Can Frailty and Sarcopenia Be Mitigated in Esophagectomy Candidates?

28. Do Enhanced Recovery Programs for Esophagectomy Patients Improve Outcomes?

29. Does Jejunostomy Tube Feeding Improve Outcomes After Esophagectomy?

30. Surgery Versus Definitive Chemoradiotherapy for Regionally Advanced Esophageal Squamous Cell Cancer

31. Robotic Minimally Invasive Esophagectomy (RAMIE) vs. Open Esophagectomy (OE) for Resectable Esophageal Cancer

32. Two-Field vs. Three-Field Lymphadenectomy for Esophageal Adenocarcinoma

33. What Is the Appropriate Extent of Lymph Node Dissection in Esophageal Cancer

34. Salvage Esophagectomy for Persistent or Recurrent Disease After Chemoradiation

35. Early Oral Feeding After Esophagectomy

36. Stent vs. Primary Repair for Esophageal Perforation

37. Endoluminal Vacuum Therapy vs. Stenting for Esophageal Anastomotic Leaks

38. Thoracoscopic Versus Endoscopic Therapy for Small Sub-epithelial Esophageal Tumors

39. Laparoscopic vs. Endoscopic Therapy for Achalasia

40. Laparoscopy or Endoscopic Therapy for Recurrent Symptoms from Achalasia

41. Laparoscopy or Thoracotomy for Symptomatic Recurrent Paraesophageal Hernia

Part III. Diaphragm

42. Does Diaphragm Pacing for Bilateral Phrenic Nerve Paralysis Improve Function or Quality of Life?

43. Does Phrenic Nerve Reconstruction for Unilateral Diaphragm Paralysis Improve Function or Quality of Life

44. Is Plication for Diaphragmatic Eventration Effective in Improving Lung Function?

Part IV. Airways

45. Is Long-Term Stenting for Benign Airway Obstruction Effective?

46. Are Engineered Tissues Useful for Tracheal Reconstruction?

47. Management of Positive Margins After Resection of Primary Tracheal Malignancies

48. Optimal Management of Posttransplant Bronchial Stenosis: Stenting or Reoperation

Part V. Pleura and Pleural Spaces

49. Is tPA/DNase Effective in the Management of Pleural Empyema?

50. VATS vs Open Management of Pleural Empyema

51. Indwelling Pleural Catheters Versus Talc Pleurodesis for Recurrent Symptomatic Malignant Pleural Effusions

52. Quality of Life: Extended Pleurectomy/Decortication vs Extrapleural Pneumonectomy

Part VI. Mediastinum

53. Does Thymectomy Improve Outcomes in Patients with Nonthymomatous Myasthenia Gravis?

54. Magnetic Resonance Imaging for Evaluation of Suspected Encapsulated Thymoma

55. Robotic vs. Thoracoscopic Thymectomy for Thymoma

56. VATS for Resection of Mediastinal Parathyroid Adenomas

57. Thymectomy in the Setting of Pleural Metastasis

58. Sympathectomy for Malignant Ventricular Arrhythmias

59. The Extent of Surgery for Palmar Hyperhidrosis

Part VII. Chest Wall

60. Synthetic Versus Biologic Reconstruction of Bony Chest Wall Defects

61. Traumatic Rib Fracture in the Absence of Flail Chest: Conservative Therapy or Surgical Fixation?

62. Is Surgical Management of Flail Chest Effective?

63. Epidural vs Regional Blocks for VATS and Thoracotomy

64. The Nuss Procedure Versus the Modified Ravitch Repair for Pectus Excavatum in Adults

Back Matter