Non- Lung Cancer Thoracic Surgery Flashcards
What are some causes for lung abscesses?
Aspiration (incl. foreign bodies), Pneumonia, PTE, Lung cancer and septic emboli
How does pneumonia cause a lung abscess?
Pneumonia develops due to blocked lobe
Infection then develops
This gives necrosis of tissue to make an abscess
What happens when the lung abscess bursts into pleural cavity?
Empyema which causes sudden onset of chest pain
How do you remove a lung abscess?
Drain is inserted
Chunk of rib taken out
What is a retroperitoneal abscess?
In space where the pancreas lies
Related to pancreas infection
Muscle is enlarged and abscess need drained
What are the causes of empyema thoracis?
Post pneumonic, post-operative, oesophageal, upper abdominal related, osteomyelitis and pot-traumatic
Explain pleurectomy
Is done to remove part of the pleura
Explain decortication
Removal of surface layer of the lung - the layer restricting lung expansions
Happens for empyema and pleural thickening
What are the different types of thymic tumours?
Thymoma, thymolipoma, thymic carcinoma, carcinoid tumours of the thymus and lymphoma
What is a thymoma?
Rare malignancy
Forms from cells of epithelium of thymus
What is a thymolipoma?
Mostly asymptomatic and benign
Are thymoma + lymphoma
What is a thymic carcinoma?
Rare and aggressive
Derived from thymic epithelium cells
Tend to invade locally
What is a carcinoid tumour of the thymus?
Carcinoid is a slow growing tumour
Usually not curable by surgery
Why would a patient need tracheal surgery?
Repair of iatrogenic injury
Tracheal tumours - salivary gland tumours or squamous carcinomas
What are some benign lung tumours?
Hamartoma, Fibroma, lipoma, Neural tumours, Papillomas and chondroma
Possible carcinoid
Why should neural tumours be removed?
Tumour can invade intercostal, phrenic, vegus nerve or sympathetic trunk.
Can be malignant also
What is the most common benign lung tumour?
Hamartoma
What benign lung tumours should be removed as can grow too big?
Fibroma and Lipoma
What is a primary pneumothorax?
No primary abnormality
What is a secondary pneumothorax?
A pneumothorax in a patient who has COPD or pulmonary fibrosis (underlying lung disease)
Usually widespread pneumothorax
What is the difference between recurrent vs persistent pneumothorax?
Recurrent is when the patient has had 2 or more
Persistent is when the air leak wont stop
What is an open pneumothorax?
Occurs when air accumulates between the chest wall and the lung as the result of an open chest wound or other physical defect
Inefficient ventilation
Rag with water over hole to prevent air coming in
What happens to structures in thoracic cavity when there is a tension pneumothorax?
Heart and structures move to other side from collapsed lung due to the build up of pressure - air is leaving the lung but nothing is going back in
How would you treat a patient with bilateral pneumothorax?
Drains are inserted into both sides
Surgery with talc pleurodesis to prevent recurrence - one lung at a time and talc is sprayed
If bulla then stapled
What is the treatment for spontaneous haemopneumothorax?
Lung has collapsed and teared chest adhesion
Bleeding in 50% stops themselves
Bullectomy and talc pleurodesis
What is bullous lung disease?
Abnormal air space that is more than 2cm in diameter Under 2cm is a bleb
What happen in bullous lung disease if patients goes on aircraft?
Aircraft caused pressure so bullous doubles in volume
Can cause pneumothorax or tearing of veins
Air can embolise in veins so can end in brain and cause stroke
What are the indications for surgery in a pneumothorax?
Recurrence
Persistence
Sometimes can be given after 1 episode if driver or army - international travel
What is the surgery for pneumothorax?
Pleurodesis
Pleurectomy
Explain bronchogenic cysts?
Present from birth
Cause symptoms by pressing on trachea or oesophagus - dysphagia or stridor
What is the name of the group of cysts that bronchogenic cysts belong to?
Foregut duplication cysts
What respiratory disease may need a lung transplant?
CF, Pulmonary fibrosis and emphysema (alpha-1 antitrypsin deficiency)
Is CF a double or single transplant?
Need double lung transplant
due to bronchiectasis
Causes repeated infections
What are the indications for a lung transplant?
Under 65, not overweight, not diabetic, no renal failure, no mental illness and good social support
