Download Thoracic Surgery: Lung Resections, Bronchoplasty by Douglas J. Mathisen MD, Christopher Morse PDF
By Douglas J. Mathisen MD, Christopher Morse
Take your surgical abilities to the subsequent point with Thoracic surgical procedure: Lung Resections, Bronchoplasty a quantity within the grasp strategies in surgical procedure sequence! This thoracic surgical procedure reference offers the richly illustrated, step by step tips you must excellent a whole variety of pulmonary resection innovations, keep away from and deal with issues, and accomplish optimum results.
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Extra info for Thoracic Surgery: Lung Resections, Bronchoplasty
Sample text
However, in some settings, expandable stents may provide the only remedy if silicone stents cannot be well seated due to absence of a fixed stenosis, especially if other options for stent fixation such as carinal Y stent or tracheal T-tube are not better alternatives. Covered self-expandable stents are also the preferred alternatives in these settings (Fig. 4). 3 Expandable metal stents can be uncovered (A) or covered (B). Covered stents are easier to remove but tissue and tumor ingrowth can occur at the uncovered ends.
The most common benign cause of central airway obstruction occurs from postintubation stenosis; typically due to prolonged intubation. Other benign etiologies causing central airway obstruction include infectious and inflammatory processes such as tuberculosis, Wegener’s disease, relapsing polychondritis, fibrosing mediastinitis, and endobronchial papillomatosis. The thoracic surgeon should adhere to the basic principle of treating central airway obstructions caused by benign disorders with curative surgical resection if at all feasible.
The most serious complication occurs in those patients who have tracheal stenosis and flexible bronchoscopy is used in the outpatient setting. Repeated attempts at intubating the patient can convert a marginal airway into a critical airway and should be avoided at all costs. If one encounters an unsuspecting stenosis, it is best to view it from above the stenosis and not manipulate the bronchoscope across it and thereby reducing the chance for bleeding or edema and loss of the airway. Special note should be made of those patients who have tracheobronchial trauma.