Preoperative preparation of patients for thoracic surgery:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2005
|
| Schriftenreihe: | Thoracic surgery clinics
15,2 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | VIII, 190 - 322 S. Ill., graph. Darst. |
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| 245 | 1 | 0 | |a Preoperative preparation of patients for thoracic surgery |c guest ed. Richard I. Whyte |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 2005 | |
| 300 | |a VIII, 190 - 322 S. |b Ill., graph. Darst. | ||
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CONTENTS
Preface xi
Richard I. Whyte
Smoking Cessation: Techniques and Potential Benefits 189
Tomasz M. Ziedalski and Stephen J. Ruoss
Tobacco smoking significantly increases the risk of perioperative and postoperative com¬
plications. Observational evidence suggests that preoperative smoking cessation may
decrease the risk of certain complications. Smoking cessation programs that employ
behavioral and cognitive therapy and pharmacotherapy have been used successfully in
many situations and should be used to discourage smoking preoperatively. Further eval¬
uation of the effectiveness of particular types of interventions is needed to clarify the best
approach to smoking cessation for surgical patients.
Preoperative Patient Education in Thoracic Surgery 195
Richard I. Whyte and Patricia D. Grant
This article describes the role of preoperative teaching in thoracic surgery. Preoperative
patient teaching may take many forms and is offered to patients across many venues and
formats. The goal of patient teaching is to improve patients understanding of their dis¬
ease process and the operation that they are about to experience with the goal of enlist¬
ing their active participation in the healing process. The additional goal of obtaining
informed consent is not only codified in law, but also has become an ingrained compo¬
nent to the current physician patient relationship. The preoperative teaching process is
best approached as a team effort, and multiple modalities often must be used so that the
patient becomes a knowledgeable and willing member of the team.
The Value of Preoperative Pulmonary Rehabilitation 203
Shanon T. Takaoka and Ann B. Weinacker
Although pulmonary rehabilitation is potentially beneficial before any surgery, it has
been applied and studied primarily in the setting of major thoracic surgical procedures,
including lung volume reduction surgery, lung transplantation, and lung resection. This
article defines the essential elements of pulmonary rehabilitation, outlines the prerequi¬
sites for enrollment, and discusses its current role in the setting of anticipated thoracic
surgery. Pulmonary rehabilitation seems to be a cost effective, benign intervention with
no adverse effects and should remain an essential component of patient management
before lung transplantation, lung volume reduction surgery, lung resection, and poten¬
tially any other elective thoracic surgical procedure.
VOLUME 15 • NUMBER 2 • MAY 2005 v
Informed Consent: Ethical and Legal Aspects 213
Carole A. Klove, Sarah J. DiBoise, Betty Pang, and William C. Yarbrough
The doctrine of informed consent serves the dual function of promoting the beneficence,
benevolence, and nonmalfeasance of the physician and the autonomy, bodily integrity
and self determination of the patient. Conflict arises when a patient s individual liberty
rights clash with a physician s medical conclusions formed in the patient s perceived
best interest. This article explores the ethical and legal nuances of the doctrine of
informed consent in an attempt to empower the provider with a deeper understanding
of the physician s rights and responsibilities in obtaining a true informed consent.
Fast Tracking: Eliminating Roadblocks to Successful Early Discharge 221
Jules Lin and Mark D. Iannettoni
This article describes common obstacles to successful early discharge that face many
thoracic surgeons despite technically successful procedures; these obstacles include
inadequate pain control, prolonged air leaks, and social issues. With continually increas¬
ing health care costs and limited resources, identifying the factors that affect length of
stay has taken on new importance. Potential solutions that also maintain the quality of
patient care are discussed and include the use of minimally invasive techniques, opti¬
mizing pain control, early mobilization, discharge planning, patient education, and the
development of clinical pathways.
Perioperative Antibiotics: When, Why? 229
Mark S. Allen
The use of prophylactic antibiotics in general thoracic surgery is well established. This
article explains the rationale for modern day surgical wound infection prophylaxis, the
why and the when. Various arguments about the use of antibiotics to prevent empyema
and pneumonia after a thoracic operation also are presented.
Pulmonary Embolism Prophylaxis: Evidence for Utility in Thoracic Surgery 237
Dean M. Donahue
Patients requiring thoracotomy for the treatment of malignancy are at risk for develop¬
ing a pulmonary embolism. Few data exist on effective prophylaxis techniques in this
specific patient population, yet effective strategies can be inferred from other major sur¬
gical procedures to reduce the risk of this potentially life threatening complication.
Management of the Anticoagulated Patient 243
Mark H. Meissner and Riyad Karmy Jones
Patients who are to undergo surgery may be anticoagulated for therapeutic reasons
(eg, deep venous thrombosis, valve replacement, lytic therapy) or because of comorbid
conditions (eg, renal or hepatic failure). In addition, the proposed operative intervention
may be elective or urgent. The approach to managing the coagulation status is critically
affected by the circumstances and requires a basic understanding of the risks involved of
bleeding and correcting the underlying pathophysiology. This article reviews the indica¬
tions, pharmacology and complications of common anticoagulation therapies (including
laboratory and clinical assessment) in the surgical patient.
vi CONTENTS
Preoperative Cardiac Evaluation: Mechanisms, Assessment, and
Reduction of Risk 263
Euan A. Ashley and Randall H. Vagelos
Considerable uncertainty exists as to when it is appropriate to investigate cardiac disease in
a preoperative thoracic patient and which tools are best suited to the task. Common disease
origins, commonality of symptoms, and coexistent disease all serve to make accurate diag¬
nosis and effective risk prediction difficult. Interventions known to reduce risk and save
lives are few. This article explores the basis for anesthetic risk in cardiovascular and pul¬
monary disease. Common disease mechanisms and the utility of tools available to assess risk
are discussed. Risk reduction also is discussed, and recommendations specific to the pre¬
operative cardiac evaluation of the thoracic surgery patient are offered.
Preoperative Preparation for Esophageal Surgery 277
Jessica Scott Donington
Esophageal surgeries can be placed into two broad categories: anatomic modifications
for benign esophageal disorders and resections for carcinomas. The clinical setting and
scope of intervention are different for these two groups, as is the preoperative prepara¬
tion. The goal of preoperative evaluation for benign esophageal disease is to make an
accurate and complete diagnosis; the tools for this include barium esophagogram,
endoscopy, pH monitoring, and manometry. The preoperative concerns for esophageal
resection for cancer involve accurate staging of the cancer, using CT, positron emission
tomography, and endoscopic ultrasound, and complete physiologic evaluation of the
patient to determine his or her ability to withstand a large operation.
Preoperative Preparation of the Patient with Myasthenia Gravis 287
Kemp H. Kernstine
The morbidity and mortality of patients with myasthenia gravis undergoing thymectomy
can be substantial. The surgeon must have a thorough knowledge of the evaluation and
tests necessary to confirm a diagnosis and should not rely totally on the neurologist s
assessment. Through partnership with the neurologist, the ideal means of medical and
surgical management can be achieved.
Preoperative Pulmonary Evaluation of the Thoracic Surgical Patient 297
Aditya K. Kaza and John D. Mitchell
Surgery remains the mainstay of therapy for early stage non small lung cancer. Many
patients have poor underlying pulmonary function, in large part resulting from long term
tobacco abuse. It is the responsibility of the thoracic surgeon to assess accurately the pul¬
monary function of a potentially operable patient at the time of the preoperative evaluation.
This assessment provides an objective risk profile associated with the planned pulmonary
resection for the patient and family, minimizes morbidity and mortality, and in some cases
leads the surgeon to recommend alternative therapies. This article provides a systematic
approach to the pulmonary evaluation of the thoracic surgical patient.
The Preoperative Anesthesia Evaluation 305
Clifford A. Schmiesing and Jay B. Brodsky
Timely and thorough preoperative assessment is a cornerstone of excellent patient
outcomes and efficient use of medical resources. This article focuses on the important
elements of the preoperative anesthetic assessment of a patient presenting for thoracic
CONTENTS vii
surgery. Areas of shared concern between the surgeon and anesthesiologist are
emphasized. Cardiovascular risk assessment and preoperative management are high¬
lighted because cardiorespiratory complications are the major causes of morbidity
after thoracic surgery. Practical and simple strategies for common preoperative issues,
including medications and diagnostic testing, are provided, and the benefits of a com¬
prehensive anesthesia preoperative assessment are discussed.
Index 317
viii CONTENTS
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| series | Thoracic surgery clinics |
| series2 | Thoracic surgery clinics |
| spelling | Preoperative preparation of patients for thoracic surgery guest ed. Richard I. Whyte Philadelphia [u.a.] Saunders 2005 VIII, 190 - 322 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Thoracic surgery clinics 15,2 Thoraxchirurgie (DE-588)4059934-6 gnd rswk-swf Präoperative Phase (DE-588)4307863-1 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Thoraxchirurgie (DE-588)4059934-6 s Präoperative Phase (DE-588)4307863-1 s b DE-604 Whyte, Richard I. Sonstige oth Thoracic surgery clinics 15,2 (DE-604)BV019335438 15,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=013207429&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Preoperative preparation of patients for thoracic surgery Thoracic surgery clinics Thoraxchirurgie (DE-588)4059934-6 gnd Präoperative Phase (DE-588)4307863-1 gnd |
| subject_GND | (DE-588)4059934-6 (DE-588)4307863-1 (DE-588)4143413-4 |
| title | Preoperative preparation of patients for thoracic surgery |
| title_auth | Preoperative preparation of patients for thoracic surgery |
| title_exact_search | Preoperative preparation of patients for thoracic surgery |
| title_full | Preoperative preparation of patients for thoracic surgery guest ed. Richard I. Whyte |
| title_fullStr | Preoperative preparation of patients for thoracic surgery guest ed. Richard I. Whyte |
| title_full_unstemmed | Preoperative preparation of patients for thoracic surgery guest ed. Richard I. Whyte |
| title_short | Preoperative preparation of patients for thoracic surgery |
| title_sort | preoperative preparation of patients for thoracic surgery |
| topic | Thoraxchirurgie (DE-588)4059934-6 gnd Präoperative Phase (DE-588)4307863-1 gnd |
| topic_facet | Thoraxchirurgie Präoperative Phase Aufsatzsammlung |
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