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Extrapleural Pneumonectomy

  • Ju-Mei NgEmail author
Chapter

Abstract

Extrapleural pneumonectomy (EPP) is a formidable surgical procedure performed on patients with limited life expectancy. Anesthetic management may contribute to containment of perioperative morbidity and mortality through the control of intraoperative physiologic disruptions and postoperative pain and an appreciation of the associated postoperative complications to affect early intervention. “EPP-specific” anesthetic concerns (above those for standard pneumonectomy) are discussed.

Keywords

Anesthetic management Extrapleural pneumonectomy Mesothelioma Chemotherapy 

References

  1. 1.
    Wolf AS, Flores RM. Extrapleural pneumonectomy for pleural malignancies. Thorac Surg Clin. 2014;24:471–5.CrossRefGoogle Scholar
  2. 2.
    Butchart EG, Ashcroft T, Barnsley WC, Holden MP. Pleuropneumonectomy in the management of diffuse malignant mesothelioma of the pleura. Experience with 29 patients. Thorax. 1976;31(1):15–24.CrossRefGoogle Scholar
  3. 3.
    Cao CQ, Yan TD, Bannon PG, McCaughan BC. A systematic review of extrapleural pneumonectomy for malignant pleural mesothelioma. J Thorac Oncol. 2010;5:1692–703.CrossRefGoogle Scholar
  4. 4.
    Burt BM, Cameron RB, Mollberg NM, Kosinski AS, Schipper PH, Shrager JB, et al. Malignant pleural mesothelioma and the Society of Thoracic Surgeons database: an analysis of surgical morbidity and mortality. J Thorac Cardiovasc Surg. 2014;148:30–5.CrossRefGoogle Scholar
  5. 5.
    Sugarbaker DJ, Jaklitsch MT, Bueno R, Richards W, Lukanich J, Mentzer SJ, et al. Prevention, early detection, and management of complications after 328 consecutive extrapleural pneumonectomies. J Thorac Cardiovasc Surg. 2004;128(1):138–46.CrossRefGoogle Scholar
  6. 6.
    Sugarbaker DJ, Flores RM, Jaklitsch MT, Richards WG, Strauss GM, Corson JM, et al. Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results in 183 patients. J Thorac Cardiovasc Surg. 1999;117(1):54–63. discussion 63-5.CrossRefGoogle Scholar
  7. 7.
    Tilleman TR, Richards WG, Zellos L, Johnson BE, Jaklitsch MT, Mueller J, et al. Extrapleural pneumonectomy followed by intracavitary intraoperative hyperthermic cisplatin with pharmacologic cytoprotection for treatment of malignant pleural mesothelioma: a phase II prospective study. J Thorac Cardiovasc Surg. 2009;138(2):405–11.CrossRefGoogle Scholar
  8. 8.
    Rusch V, Baldini EH, Bueno R, De Perrot M, Flores R, Hasegawa S, et al. The role of surgical cytoreduction in the treatment of malignant pleural mesothelioma: meeting summary of the international mesothelioma interest group congress, September 11-14, 2012, Boston, Mass. J Thorac Cardiovasc Surg. 2013;145(4):909–10.CrossRefGoogle Scholar
  9. 9.
    Cao C, Tian D, Manganas C, Matthews P, Yan TD. Systematic review of trimodality therapy for patients with malignant pleural mesothelioma. Ann Cardiothorac Surg. 2012;1(4):428–37.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Hartigan PM, Ng JM. Anesthetic strategies for patients undergoing extrapleural pneumonectomy. Thorac Surg Clin. 2004;14(4):575–83, xi.CrossRefGoogle Scholar
  11. 11.
    Ng JM, Hartigan PM. Anesthetic management of patients undergoing extrapleural pneumonectomy for mesothelioma. Curr Opin Anaesthesiol. 2008;21(1):21–7.CrossRefGoogle Scholar
  12. 12.
    Zellos L, Christiani DC. Epidemiology, biologic behavior, and natural history of mesothelioma. Thorac Surg Clin. 2004;14(4):469–77, viii.CrossRefGoogle Scholar
  13. 13.
    Wagner JC, Sleggs CA, Marchand P. Diffuse pleural mesothelioma and asbestos exposure in the North Western Cape Province. Br J Ind Med. 1960;17:260–71.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Carbone M, Kratzke RA, Testa JR. The pathogenesis of mesothelioma. Semin Oncol. 2002;29(1):2–17.CrossRefGoogle Scholar
  15. 15.
    Teta MJ, Mink PJ, Lau E, Sceurman BK, Foster ED. US mesothelioma patterns 1973-2002: indicators of change and insights into background rates. Eur J Cancer Prev. 2008;17(6):525–34.CrossRefGoogle Scholar
  16. 16.
    Carroll N, Mohamed F, Sugarbaker P. Hyperthermic chemoperfusion, and postoperative chemotherapy: The National Cancer Institute and Washington hospital center experience. In: Pass H, Vogelzang N, Carbone M, editors. Malignant mesothelioma: advances in pathogenesis, diagnosis and translational therapies. New York: Springer; 2005. p. 732–54.CrossRefGoogle Scholar
  17. 17.
    Lee JM, Sugarbaker DJ. Extrapleural pneumonectomy for pleural malignancies. In: Sugarbaker DJ, Bueno R, Colson YL, Jaktlisch MT, Krasna MJ, Mentzer SJ, editors. Adult chest surgery. 2nd ed. New York: McGraw-Hill Professional; 2015. p. 998–1009.Google Scholar
  18. 18.
    Reilly JJ Jr. Evidence-based preoperative evaluation of candidates for thoracotomy. Chest. 1999;116(6 Suppl):S474–6.CrossRefGoogle Scholar
  19. 19.
    Amar D, Burt ME, Roistacher N, Reinsel RA, Ginsberg RJ, Wilson RS. Value of perioperative Doppler echocardiography in patients undergoing major lung resection. Ann Thorac Surg. 1996;61(2):516–20.CrossRefGoogle Scholar
  20. 20.
    Gill RR, Gerbaudo VH, Sugarbaker DJ, Hatabu H. Current trends in radiologic management of malignant pleural mesothelioma. Semin Thorac Cardiovasc Surg. 2009;21(2):111–20.CrossRefGoogle Scholar
  21. 21.
    Slinger P. Update on anesthetic management for pneumonectomy. Curr Opin Anaesthesiol. 2009;22(1):31–7.CrossRefGoogle Scholar
  22. 22.
    Wittnich C, Trudel J, Zidulka A, Chiu RC. Misleading “pulmonary wedge pressure” after pneumonectomy: its importance in postoperative fluid therapy. Ann Thorac Surg. 1986;42(2):192–6.CrossRefGoogle Scholar
  23. 23.
    Brister NW, Barnette RE, Kim V, Keresztury M. Anesthetic considerations in candidates for lung volume reduction surgery. Proc Am Thorac Soc. 2008;5(4):432–7.CrossRefGoogle Scholar
  24. 24.
    Ballantyne JC, Carr DB, deFerranti S, Suarez T, Lau J, Chalmers TC, et al. The comparative effects of postoperative analgesic therapies on pulmonary outcome: cumulative meta-analyses of randomized, controlled trials. Anesth Analg. 1998;86(3):598–612.CrossRefGoogle Scholar
  25. 25.
    Beattie WS, Badner NH, Choi P. Epidural analgesia reduces postoperative myocardial infarction: a meta-analysis. Anesth Analg. 2001;93(4):853–8.CrossRefGoogle Scholar
  26. 26.
    Oka T, Ozawa Y, Ohkubo Y. Thoracic epidural bupivacaine attenuates supraventricular tachyarrhythmias after pulmonary resection. Anesth Analg. 2001;93(2):253–9. 1st contents page.PubMedGoogle Scholar
  27. 27.
    Nino M, Body SC, Hartigan PM. The use of a bronchial blocker to rescue an ill-fitting double-lumen endotracheal tube. Anesth Analg. 2000;91(6):1370–1, TOC.CrossRefGoogle Scholar
  28. 28.
    Senturk M, Slinger P, Cohen E. Intraoperative mechanical ventilation strategies for one-lung ventilation. Best Prac Res Clin Anaesthesiol. 2015;29(3):357–69.CrossRefGoogle Scholar
  29. 29.
    Hurford WE, Kolker AC, Strauss HW. The use of ventilation/perfusion lung scans to predict oxygenation during one-lung anesthesia. Anesthesiology. 1987;67(5):841–4.CrossRefGoogle Scholar
  30. 30.
    Bakaeen F, Rice D, Correa AM, Walsh GL, Vaporciyan AA, Putnam JB, et al. Use of aprotinin in extrapleural pneumonectomy: effect on hemostasis and incidence of complications. Ann Thorac Surg. 2007;84(3):982–6.CrossRefGoogle Scholar
  31. 31.
    Slinger PD. Perioperative fluid management for thoracic surgery: the puzzle of postpneumonectomy pulmonary edema. J Cardiothorac Vasc Anesth. 1995;9(4):442–51.CrossRefGoogle Scholar
  32. 32.
    Schipper PH, Nichols FC, Thomse KM, Deschamps C, Cassivi SD, Allen MS, et al. Malignant pleural mesothelioma: surgical management in 285 patients. Ann Thorac Surg. 2008;85(1):257–64.CrossRefGoogle Scholar
  33. 33.
    Stewart DJ, Martin-Ucar AE, Edwards JG, West K, Waller DA. Extra-pleural pneumonectomy for malignant pleural mesothelioma: the risks of induction chemotherapy, right-sided procedures and prolonged operations. Eur J Cardiothorac Surg. 2005;27(3):373–8.CrossRefGoogle Scholar
  34. 34.
    de Perrot M, McRae K, Anraku M, Karkouti K, Waddell TK, Pierre AF, et al. Risk factors for major complications after extrapleural pneumonectomy for malignant pleural mesothelioma. Ann Thorac Surg. 2008;85(4):1206–10.CrossRefGoogle Scholar
  35. 35.
    Passman RS, Gingold DS, Amar D, Lloyd-Jones D, Bennett CL, Zhang H, et al. Prediction rule for atrial fibrillation after major noncardiac thoracic surgery. Ann Thorac Surg. 2005;79(5):1698–703.CrossRefGoogle Scholar
  36. 36.
    Roselli EE, Murthy SC, Rice TW, Houghtaling PL, Pierce CD, Karchmer DP, et al. Atrial fibrillation complicating lung cancer resection. J Thorac Cardiovasc Surg. 2005;130(2):438–44.CrossRefGoogle Scholar
  37. 37.
    Frendl G, Sodickson AC, Chung MK, Waldo AL, Gersh BJ, Tisdale JE, et al. 2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures. Executive summary. J Thorac Cardiovasc Surg. 2014;148(3):772–91.CrossRefGoogle Scholar
  38. 38.
    Brown MJ, Brown DR. Thoracic cavity irrigation: an unusual cause of acute ST segment increase. Anesth Analg. 2002;95(3):552–4, table of contents.PubMedGoogle Scholar
  39. 39.
    Obata H, Saito S, Fujita N, Fuse Y, Ishizaki K, Goto F. Epidural block with mepivacaine before surgery reduces long-term post-thoracotomy pain. Can J Anaesth. 1999;46(12):1127–32.CrossRefGoogle Scholar
  40. 40.
    Senturk M, Ozcan PE, Talu GK, Kiyan E, Camci E, Ozyalcin S, et al. The effects of three different analgesia techniques on long-term postthoracotomy pain. Anesth Analg. 2002;94(1):11–5, table of contents.CrossRefGoogle Scholar
  41. 41.
    Suzuki M, Haraguti S, Sugimoto K, Kikutani T, Shimada Y. Sakamoto A. Low-dose intravenous ketamine potentiates epidural analgesia after thoracotomy. Anesthesiology. 2006;105(1):111–9.CrossRefGoogle Scholar
  42. 42.
    Wolf AS, Daniel J, Sugarbaker DJ. Surgical techniques for multimodality treatment of malignant pleural mesothelioma: extrapleural pneumonectomy and pleurectomy/decortication. Semin Thorac Cardiovasc Surg. 2009;21(2):132–48.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Anesthesiology, Perioperative and Pain MedicineBrigham and Women’s HospitalBostonUSA

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