Management of benign and malignant pleural effusions:
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| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia, Pa.
Elsevier
2013
|
| Series: | Thoracic surgery clinics
23,1 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | VIII, 101 S. Ill., graph. Darst. |
| ISBN: | 9781455773398 |
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| 245 | 1 | 0 | |a Management of benign and malignant pleural effusions |c ed.: Cliff K. C. Choong |
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Record in the Search Index
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| adam_text | Contents
Preface:
Management
of Benign and Malignant
Pleural
Effusions
ix
Cliff K.CChoong
Anatomy and Pathophysiology of the Pleura and
Pleural
Space
1
Nilay Gamze Yalcin, Cliff K.C. Choong, and Norman Eizenberg
Pleural effusions
are most often secondary to an underlying condition and may be
the first sign of the underlying pathologic condition. The balance between the hydro¬
static and oncotic forces dictates
pleural
fluid homeostasis. The parietal pleura has
a more significant role in
pleural
fluid homeostasis. Its vessels are closer to the
pleu¬
ral
space compared with its visceral counterpart; it contains lymphatic
stornata,
absent on visceral pleura, which are responsible for a bulk clearance of fluid. The
diagnosis and successful treatment of
pleural
effusions requires a mixture of imaging
techniques and
pleural
fluid analysis.
Decision Making and Algorithm for the Management of
Pleural
Effusions
11
Tam
Quinn, Naveed
Alam,
Ali
Aminazad, M.
Blair
Marshall,
and Cliff K.C. Choong
Pleural
effusions can be catagorised in to transudative effusions or exudative effu¬
sions. Causes include cardiovascular disease, infection and neoplasm. Diagnosis is
the key to determining what management is required. History and examination can
elicit the cause of the effusion and radiological investigations can be a useful adjunct.
Thoracocentesis and laboratory testing of the
pleurai
fluid is usually diagnostic and
can direct futher investigations or treatment. Management of the
pleural
effusion ulti¬
mately varies according to the diagnosis but can be either directed towards reversing
the cause of the effusion or treating the symptoms that arise as a result of the effusion.
Large-Bore and Small-Bore Chest Tubes: Types, Function, and Placement
17
David T. Cooke and Elizabeth A. David
Chest tubes are placed in the
pleural
space, either surgically or percutaneously to
evacuate abnormal fluid and air. Indications for chest tubes include therapeutic
drainage of
pleural
conditions such as
pneumothorax, hemothorax,
empyema, chy-
lothorax, and malignant effusions, as well as prophylaxis drainage of air, blood, and
other fluids after chest surgery. This article characterizes the types of chest tubes,
reviews the basic techniques for insertion, and describes the comparative effective¬
ness between large-bore and small-bore chest tubes.
Causes and Management of Common Benign
Pleural
Effusions
25
Rajesh Thomas and Y.C. Gary Lee
Benign
pleural
effusions are twice as common as malignant effusions and have
diverse causes and manifestations, which often makes them a diagnostic challenge.
Differentiating effusions as a transudate or
exúdate
is the first, and often helpful, step
in directing investigations for diagnosis and management. Congestive heart failure
and hepatic
hydrothorax
are the commonest causes for a transudative effusion.
Commonly exudative effusions are caused by infections or may be secondary to pul¬
monary embolism, drugs, collagen vascular diseases, or may follow cardiac surgery.
v¡
Contents
This article gives an overview of the causes and management of common benign
pleural
effusions.
Surgical Management of Malignant
Pleural
Effusions
43
Sudish C. Murthy and Thomas W. Rice
The two reasonable options for surgical management of malignant
pleural
effusions
are tunneled
pleural
catheters and video-assisted thoracic surgery with talc pleurod-
esis. Successful palliation demands balancing the patient s wishes, performance
status, and prognosis with the ability to obtain full lung expansion and control fluid
production. There is no ideal procedure; surgical treatment must be individualized.
Pleurectomy Decortication in the Treatment of the Trapped Lung in Benign and
Malignant
Pleural
Effusions
51
Sridhar Rathinam and David A. Waller
Trapped lung is defined by the inability of the lung to expand and fill the thoracic cav¬
ity because of a restricting peel. This restriction may be secondary to a benign in¬
flammatory or fibrotic cortex or to a malignant visceral
pleural
tumor. This condition
has a significant impact on the patient s quality of life by causing dyspnea. This
article discusses the role of surgery in relieving the trapped lung, including decorti¬
cation in benign disease and pleurectomy in malignant disease. The surgical
approaches of video-assisted thoracoscopy and thoracotomy are contrasted and
the future potential for surgical trials in this condition is outlined.
Permanent Indwelling Catheters in the Management of
Pleural
Effusions
63
Jacob
Gillen
and Christine
Lau
The treatment of chronic recurrent
pleural
effusions continues to evolve with the re¬
cent emergence of tunneled indwelling
pleural
catheters (IPCs). Talc pleurodesis has
been the standard of care for treatment of recurrent
pleural
effusions, but IPCs have
gained more favor in recent years. IPCs offer several advantages, including a less
invasive procedure, short postprocedure hospital stay, and greater patient control
in the management of symptoms. Further randomized controlled studies are needed
to more clearly differentiate which patients are better served by an I PC rather than
traditional pleurodesis as their initial intervention.
Surgical Management of Malignant
Pleural Mesothelioma
73
Jane Yanagawa and Valerie Rusch
The uniquely diffuse nature of malignant
pleural
mesothelioma (MPM) makes it dif¬
ficult to diagnose, stage, and treat. In addition, it is a relatively uncommon disease,
making adequate prospective trials difficult to perform and leading to several contro¬
versies regarding the best management of MPM. Perhaps the greatest area of dis¬
pute is whether
extrapleural
pneumonectomy or pleurectomy/decortication is the
most appropriate curative operation for patients who are physiologically candidates
for both. Although median survival remains poor, important strides have been made
in the treatment of MPM, mainly in the form of multimodality therapeutic regimens.
Hemothorax: Etiology, Diagnosis, and Management
89
Stephen R.
Broderick
Most cases of hemothorax are related to blunt or penetrating chest trauma. Criteria
for surgical intervention for initial hemothorax are well defined. Appropriate
Contents
vii
management
of retained hemothorax following initial trauma management is critical,
and the best approach remains controversial. Spontaneous hemothorax is much
less common and results from a variety of pathologic processes. This article reviews
the etiology, diagnosis, and treatment of traumatic and spontaneous hemothorax in
modern practice.
Index
97
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| spelling | Management of benign and malignant pleural effusions ed.: Cliff K. C. Choong Philadelphia, Pa. Elsevier 2013 VIII, 101 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Thoracic surgery clinics 23,1 Pleuraerguss (DE-588)4174914-5 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Pleuraerguss (DE-588)4174914-5 s DE-604 Choong, Cliff K. Sonstige (DE-588)138767971 oth Thoracic surgery clinics 23,1 (DE-604)BV019335438 23,1 Digitalisierung UB Regensburg application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=025684633&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| title | Management of benign and malignant pleural effusions |
| title_auth | Management of benign and malignant pleural effusions |
| title_exact_search | Management of benign and malignant pleural effusions |
| title_full | Management of benign and malignant pleural effusions ed.: Cliff K. C. Choong |
| title_fullStr | Management of benign and malignant pleural effusions ed.: Cliff K. C. Choong |
| title_full_unstemmed | Management of benign and malignant pleural effusions ed.: Cliff K. C. Choong |
| title_short | Management of benign and malignant pleural effusions |
| title_sort | management of benign and malignant pleural effusions |
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