Anesthetic management of patients undergoing extrapleural pneumonectomy for mesothelioma

Current Opinion in Anaesthesiology
Ju-Mei Ng, Philip M Hartigan

Abstract

Extrapleural pneumonectomy is a radical and aggressive surgery that presents a great challenge to the thoracic anesthesiologist. This surgery is performed routinely by only a few centers in the world and this review represents our institution's experience in anesthetic care. Prominent among the developing multimodal treatment options is the combination of extrapleural pneumonectomy with intraoperative intracavitary hyperthermic chemotherapy. Outcome survival benefits have recently been demonstrated for the less completely cytoreductive pleurectomy procedure when combined with intraoperative intracavitary hyperthermic chemotherapy and trials are well under way for extrapleural pneumonectomy plus intraoperative intracavitary hyperthermic chemotherapy. Anesthetic management of extrapleural pneumonectomy is further impacted by these developments. Anesthetic management importantly contributes to containment of the perioperative complications of extrapleural pneumonectomy. An appreciation of the technical aspects and physiologic disruptions associated with extrapleural pneumonectomy is critical to effective management. While data on this relatively uncommon surgical procedure are scarce, some referral centers have accumulated extensi...Continue Reading

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Citations

Apr 28, 2012·Clinical Journal of the American Society of Nephrology : CJASN·K Annette MizuguchiGyorgy Frendl
Dec 3, 2014·Thoracic Surgery Clinics·Andrea S Wolf, Raja M Flores
Nov 26, 2013·Best Practice & Research. Clinical Anaesthesiology·Radha ArunkumarPascal Owusu-Agyemang
Jul 19, 2016·Thoracic Surgery Clinics·Andrea S Wolf, Raja M Flores
Mar 20, 2009·Current Opinion in Anaesthesiology·Alessia Pedoto, David Amar
Jun 29, 2014·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Robert ŚmigielskiRainer Siebold

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