Assessment and Surgical Treatment of Lung Cancer Flashcards
Assessment of Patient (5)
Staging of the lung cancer Fitness of the patient T status N status M status
History (3)
Pain (bony)
Heachaches or neurological symptoms
Haematuria
Examination (8)
Recurrent laryngeal nerve palsy Brachial plexus palsy SVC obstruction Supraclavicular LNs Soft tissue nodules Chest wall masses Pleural/pericardial effusion Hepatomegaly
CXR (4)
Pleural effusion
Chest wall effusion
Phrenic nerve palsy
Collapsed lobar/lung
Blood test
Anaemia
Abnormal LFT
Abnormal bone profile
CT scan can show
The size of tumour Mediastinal nodes Metastatic disease Proximity to mediastinal structures Diaphragmatic involvement
What test can also be used in nodal staging
PET
What other tests can be used during investigation (3)
MRI- vascular and neurological involvement in pancoast tumour
Bone scan- bone involvement
ECHO- pericardial effusion
What is a Pancoast tumour
A tumour of the pulmonary apex
Surgical investigations
Bronchoscopy
Mediastinoscopy
Respiratory Function Test for fitness for surgery
Spirometry
Diffusion studies
ABG on air/SLV (single lung ventilation)
Fractional V/Q
Cardiac Assessment for fitness for surgery (4)
ECG
ECHO
CT scan
Coronary angiogram (X-ray used to check blood vessels)
Reasons for peri-operative death (6)
ARDS- acute respiratory distress syndrome Bronchopneumonia Myocardial infarction PTE Pneumothorax Intrathoracic bleeding
Non fatal complications (7)
Post thoracotomy wound pain Empyema BPF(bronchopleural fistula) Wound infection MI AF Gastroparesis/constipation
Commonest problems (4)
Collapse of lobe or lung
Presence of another pulmonary nodule
Retrosternal thyroid
Adrenal nodule
