Abstract
The anesthetic preoperative evaluation of a patient prior to thoracic surgery can be challenging, but is frequently fruitful. Advances in anesthetic management, noninvasive surgical techniques, and intensive care have gradually but progressively lowered the threshold for declaring patients to be surgical candidates. When it is felt that a patient’s disease is amenable to complete surgical excision, the term “resectable” is employed; when it is felt that the patient can tolerate the proposed procedure, the term “operable” is utilized. The fact that surgical techniques have improved has increased the number of resectable patients, while the improvements in anesthetic and perioperative care have lowered the barriers to operability. Of the only roughly 13% of patients diagnosed with lung cancer who will be cured, virtually all be as a result of surgical resection. Thus, the incentive on the part of the patient to accept a risky operative intervention is greatly increased. The net result is that of a decreasingly robust population appearing in the preoperative evaluation clinic.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Notes
- 1.
Cahalin L, Pappagianapoulos P, Prevost S et al. The relationship of the 6-min walk test to maximal oxygen consumption in transplant candidates with end-stage lung disease. Chest 1995; 108:452–57.
Selected References
Slinger PS, Johnston MR. Preoperative assessment for pulmonary resection, 2005. http://www.thoracic-anesthesia.com/?p=23.
Colice GL, Shafazand S, Griffin JP, et al. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest. 2007;132:161S–77.
Cahalin L, Pappagianapoulos P, Prevost S, et al. The relationship of the 6-min walk test to maximal oxygen consumption in transplant candidates with end-stage lung disease. Chest. 1995;108:452–7.
Ninan M, Sommers KE, Landranau RJ, et al. Standardized exercise oximetry predicts post-pneumonectomy outcome. Ann Thorac Surg. 1995;60:603–9.
Win T, Jackson A, Groves AM, et al. Relationship of shuttle walk test and lung cancer surgical outcome. Eur J Cardiothorac Surg. 2004;26:1216–9.
Slinger PD, Karsli C. Management of the patient with a large anterior mediastinal mass: recurring myths. Curr Opin Anaesthesiol. 2007;20(1):1–3.
Osaki T, Shirakusa T, Kodate M, et al. Surgical treatment of lung cancer in the octogenarian. Ann Thorac Surg. 1994;57:188–93.
Dexter EU, Jahangir N, Kohman LJ. Resection for lung cancer in the elderly patient. Thorac Surg Clin. 2004;14:163–71.
Fleisher LA, Beckman JA, Brown KA, et al. ACC/AHA 2007 Guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation. 2007;116(17): 1971–96.
Tisdale JE, Wroblewski HA, Wall DS, et al. A randomized trial evaluating amiodarone for prevention of atrial fibrillation after pulmonary resection. Ann Thorac Surg. 2009;88:886–93.
Kramer R, Groom R, Weldner D, et al. Glycemic control and reduction of deep sternal wound infection rates: a multidisciplinary approach. Arch Surg. 2008;143:451–6.
Furnary AP, Zerr KJ, Grunkemeier GL, et al. Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures. Ann Thorac Surg. 1999;67(2):352–60.
Finfer S, Chittock DR, Su SY, et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360:283–97.
Smith PW, Wang H, Gazoni LM, et al. Obesity does not increase complications after anatomic resection for non-small cell lung cancer. Ann Thorac Surg. 2007;84:1098–105.
Warner DO. Perioperative abstinence from cigarettes. Anesthesiology. 2006;104:356–67.
Sweitzer BJ, Smetana GW. Identification and evaluation of the patient with lung disease. Anesthesiol Clin. 2009;27:673–86.
ASRA website. http://www.asra.com/consensus-statements/.
Shamberger RC, Holzman RS, Griscom NT, Tarbell NJ, Weinstein HJ, Wohl ME. Prospective evaluation by computed tomography and pulmonary function tests of children with mediastinal masses. Surgery. 1995;118:468–71.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Sadovnikoff, N. (2012). Preoperative Evaluation of the Thoracic Surgical Patient. In: Hartigan, P. (eds) Practical Handbook of Thoracic Anesthesia. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-88493-6_14
Download citation
DOI: https://doi.org/10.1007/978-0-387-88493-6_14
Published:
Publisher Name: Springer, Boston, MA
Print ISBN: 978-0-387-88492-9
Online ISBN: 978-0-387-88493-6
eBook Packages: MedicineMedicine (R0)