Perioperative Lung Function Monitoring for Anatomic Lung Resections

Kocher, Gregor J.; Gioutsos, Konstantinos; Ahler, Markus; Funke-Chambour, Manuela; Ott, Sebastian Robert; Dorn, Patrick; Lutz, Jon A.; Schmid, Ralph A.

doi:10.1016/j.athoracsur.2017.06.018

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…Postoperative respiratory impairment may be caused by various factors, including surgical factors (site of incision, postoperative pain, and type of surgical procedure), anesthetic factors (residual anesthetics, injurious mechanical ventilation, and type of anesthesia), and many other patient factors (aging and smoking history) [ 67 ]. The operative type has been considered as an important factor that affects post-surgical pulmonary function, particularly when the extent of parenchymal reduction is significant, such as after segmentectomy or lobectomy in VATS [ 68 ].…”

Section: Sapb and Lung Function Recoverymentioning

confidence: 99%

The Role of Serratus Anterior Plane Block During in Video-Assisted Thoracoscopic Surgery

et al. 2021

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Although thoracoscopy has characteristics such as a small surgical incision and low stress response, post-surgical pain after a thoracoscopic operation is no less than that after a thoracotomy. Moreover, poor post-surgical pain management is likely to cause an increased incidence of postoperative pulmonary complications (PPCs) and chronic post-surgical pain. The serratus anterior plane block (SAPB) is a regional anesthesia method whereby local anesthetics (LAs) are injected into the serratus anterior space to block the lateral cutaneous branch of the intercostal nerve, long thoracic nerve, and dorsal thoracic nerve. The block range of the SAPB covers the incisions of videoassisted thoracoscopic surgery (VATS) and the site of the chest tube, which are often located in the antero-lateral chest wall. Therefore, the SAPB can achieve effective analgesia in VATS. For example, 0.125% to 0.25% levobupivacaine (20-25 ml) is widely used for thoracic surgery, which can achieve effective analgesia and avoid adverse reactions. Moreover, it has advantages compared with thoracic segmental epidural block (TEA) and thoracic paravertebral block (TPVB), such as simple operation, increased safety, fewer complications, and hemodynamic stability. In addition, adequate analgesia is helpful for pulmonary function recovery and reduces the incidence of PPCs. This article introduces the anatomical mechanism of the SAPB, diverse operation approaches, how to choose drugs and adjuvants, and the resulting impacted area range. It summarizes the advantages and disadvantages of the SAPB compared with other analgesic methods and posits that the SAPB is beneficial to the recovery of postoperative lung function, which provides more options for postoperative analgesia after VATS.

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Section: Sapb and Lung Function Recoverymentioning

confidence: 99%

The Role of Serratus Anterior Plane Block During in Video-Assisted Thoracoscopic Surgery

et al. 2021

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“…The postoperative recovery of forced expiratory volume in 1 second has been shown to be faster in patients who undergo minimally invasive anatomic lung resection compared with OT. 37 The benefit of the VATS approach seems to disappear after 3 months, and, at that point, loss of pulmonary function is equivalent for VATS and OT. 38 Second, our study was conducted using the French administrative database, which includes all centers performing LC surgery in France whatever the type and the volume of activity.…”

Section: Postoperative Mortalitymentioning

confidence: 98%

Impact of video-assisted thoracic surgery approach on postoperative mortality after lobectomy in octogenarians

Pagès

Mariet²,

Madelaine³

et al. 2019

The Journal of Thoracic and Cardiovascular Surgery

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Objective: The number of octogenarians who present with localized lung cancer eligible for surgical resection is increasing. Video-assisted thoracic surgery lobectomy has been widely accepted, but the potential benefit in octogenarians is not well established, especially for postoperative mortality. This study aimed to assess the impact of a video-assisted thoracic surgery approach on postoperative mortality after lobectomy for lung cancer in octogenarians.Methods: From January 2005 to December 2016, all patients aged more than 80 years who received lobectomy treatment for lung cancer were retrieved from the French Administrative Database. The end point was 30-day postoperative death. A propensity score was generated with 16 pretreatment variables and used to create balanced groups with matching (578 matches 1:1). Results are reported as odds ratios and 95% confidence intervals.Results: Of the 75,892 patients operated for lobectomy during this period, 3560 were octogenarians. Video-assisted thoracic surgery was performed in 16.7% (n ¼ 597) of cases, and thoracotomy was performed in 83.23% (n ¼ 2963) of cases. From 2005 to 2016, the number of patients aged more than 80 years who were operated for lung cancer increased from 160 to 456 patients per year, and the proportion of lobectomy performed by video-assisted thoracic surgery increased as well (from 3.13% to 37.28%). Unmatched postoperative mortality was 3.85% (n ¼ 23) for video-assisted thoracic surgery versus 7.9% (n ¼ 234) for thoracotomy (P <.0001). Matched postoperative mortality was significantly lower in the video-assisted thoracic surgery approach with an odds ratio of 0.51 (95% confidence interval, 0.27-0.96; P ¼ .038).Conclusions: Video-assisted thoracic surgery was significantly associated with reduced postoperative mortality compared with open thoracotomy after lobectomy for lung cancer in octogenarians. (

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“…Pulmonary function testing during hospitalization is conducive to the early detection of pulmonary infections. Gregor et al performed postoperative pulmonary function testing in patients with lung cancer and found that the FEV1 decline at 4 days postoperatively was more notable in patients with pneumonia than in patients without pneumonia (43.2% VS 32,2%) (11). Hence, regular postoperative pulmonary function testing, combined with other diagnostic assessments such as laboratory testing, radiology, and breathing frequency, could help detect pneumonia.…”

Section: Postoperative Pulmonary Function Testingmentioning

confidence: 99%

Rapid Recovery of Postoperative Pulmonary Function in Patients With Lung Cancer and Influencing Factors

Fuzhi

Dongfang

et al. 2022

Front. Oncol.

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Among malignant tumors, lung cancer has the highest morbidity and mortality worldwide. Surgery is the first-line treatment for early-stage lung cancers, and has gradually advanced from conventional open-chest surgery to video-assisted thoracic surgery (VATS). Additionally, increasingly smaller surgical incisions and less surgical trauma have resulted in reduced pulmonary function damage. Previous studies have found that the level of pulmonary function loss and recovery is significantly correlated with postoperative complications and the quality of life. Thus, an accurate assessment of the preoperative pulmonary function and effective rehabilitation of postoperative pulmonary function are highly important for patients undergoing lung surgery. In addition, pulmonary function assessment after pulmonary rehabilitation serves as an objective indicator of the postoperative pulmonary rehabilitation status and is crucial to facilitating pulmonary function recovery. Furthermore, a complete preoperative assessment and effective rehabilitation are especially critical in elderly patients with pulmonary tumors, poor basic physiological functions, comorbid lung diseases, and other underlying diseases. In this review, we summarize the clinical significance of pulmonary function assessment in patients undergoing lung cancer surgery, postoperative changes in pulmonary function, effective pulmonary function rehabilitation, and the influencing factors of pulmonary function rehabilitation.

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Perioperative Lung Function Monitoring for Anatomic Lung Resections

Cited by 6 publications

References 9 publications

The Role of Serratus Anterior Plane Block During in Video-Assisted Thoracoscopic Surgery

The Role of Serratus Anterior Plane Block During in Video-Assisted Thoracoscopic Surgery

Impact of video-assisted thoracic surgery approach on postoperative mortality after lobectomy in octogenarians

Rapid Recovery of Postoperative Pulmonary Function in Patients With Lung Cancer and Influencing Factors

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