Thoracic Surgery Flashcards
what VO2 max is prohibitive of thoracic surgical intervention
< 10 mL/kg/min
at what FEV1 is lung surgery associated with poor outcomes
FEV1 < 40%
Boards Question:
- while performing the abdominal section of a trans-hiatal esophagectomy, currently dissecting free the mid esophagus, the anesthesiologist informs you that he is having difficulty ventilating the patient and that there appears to be a large air leak…
- what is something you must think about/do
- major concern for a large injury to the trachea
- pack the mediastinum with moist gauze, close the abdomen and perform right thoracotomy to investigate/repair potential injury
what is the name of the staging protocol is used for thymomas?
Masoka Stage
what stage of Thymoma requires neoadjuvant therapy prior to possible surgical resection?
Masoka stage III
- defined as thymoma invading adjacent structures
what is the imaging study of choice for a patient with an esophageal mass concerning for cancer?
PET-CT scan
Most common anterior mediastinal mass
Thymoma
what is the most common paraneoplastic syndrome associated with thymomas
Myasthenia Gravis
most common symptoms of Myasthenia Gravis
- weakness
- ptosis
- diplopia
- dysphagia
patient with dental infection, now with posterior mediastinitis. How would you approach surgical drainage
Thoracotomy +/- cervical exploration with chest tube placement
How do you obtain a VO2 max value on a patient
get cardiopulmonary testing
most common cause of chronic mediastinal fibrosis
Histoplasmosis
use of Chamberlin Procedure
access to anterior mediastinum in a patient with limited mobility of cervical spine
Pulmonary function cut-off for lobectomy
FEV1 > 1.5L
DLCO > 60%
