Our Summary

In simpler terms, this research paper discusses the increasing use of extracorporeal life support (ECLS) techniques in thoracic (chest) surgery. ECLS methods, like the ECMO and the Novalung iLA, help with oxygenation, blood flow, and the treatment of excess carbon dioxide in the blood. These methods have become especially useful in lung transplants, as they can prevent severe complications and make the transplant process feasible in many instances.

The paper also talks about how ECLS can aid in performing specific types of surgeries that may not be possible under normal conditions or might carry too much risk. For instance, its use can greatly help when treating advanced chest cancers that are close to or extended into the heart and large vessels. Without the ability to remove such structures along with the tumor (referred to as an R0 resection), these cancers are often not recommended for surgery or are not completely removed, which isn’t a successful outcome. Therefore, the complete removal of the tumor is the most important factor in surgery, and ECLS methods can significantly increase the chances of this happening.

FAQs

  1. What is the role of extracorporeal life support (ECLS) techniques in thoracic surgery?
  2. How do ECLS methods enhance the success of lung transplants?
  3. Can ECLS techniques improve the outcomes of surgeries for advanced chest cancers?

Doctor’s Tip

A doctor might advise a patient undergoing thoracic surgery to discuss the possibility of using extracorporeal life support techniques, such as ECMO or Novalung iLA, with their surgical team. These methods can help improve oxygenation, blood flow, and carbon dioxide removal during surgery, and may be especially beneficial in complex cases like lung transplants or surgeries for advanced chest cancers. By considering the use of ECLS, patients can potentially improve their outcomes and reduce the risks associated with their procedure.

Suitable For

Patients who are typically recommended for thoracic surgery include those with advanced chest cancers, lung transplants, severe lung diseases, or other conditions that require complex surgical interventions. These patients may benefit from the use of extracorporeal life support techniques to improve their outcomes and reduce the risks associated with surgery. Additionally, patients who are at high risk for complications during surgery, such as those with compromised lung function or cardiovascular disease, may also be recommended for thoracic surgery with the support of ECLS methods. Overall, the use of ECLS in thoracic surgery has shown promising results in improving patient outcomes and expanding the possibilities for complex surgical procedures.

Timeline

Before thoracic surgery, the patient will undergo a series of pre-operative tests and evaluations to determine their overall health status and readiness for surgery. This may include blood tests, imaging scans, lung function tests, and consultations with various specialists. The patient will also receive detailed instructions on how to prepare for surgery, such as fasting before the procedure and stopping certain medications.

During the surgery, the patient will be placed under general anesthesia, and the surgeon will make an incision in the chest to access the area of concern. Depending on the type of surgery being performed, different techniques may be used, such as minimally invasive procedures or open surgery. The surgeon will then remove or repair the affected tissue, organs, or structures in the chest.

After the surgery, the patient will be closely monitored in the intensive care unit (ICU) to ensure they are stable and recovering well. Pain management, breathing exercises, and physical therapy may be initiated to help with recovery. The patient will gradually be weaned off mechanical ventilation and other supportive measures as they regain strength and function.

Overall, the use of ECLS techniques in thoracic surgery has greatly improved outcomes for patients undergoing complex procedures, allowing for safer surgeries and better post-operative care. With advancements in technology and surgical techniques, thoracic surgery continues to evolve, offering new possibilities for patients with a range of chest conditions.

What to Ask Your Doctor

  1. How will ECLS be used during my thoracic surgery and what are the potential benefits and risks?

  2. What are the success rates of using ECLS in thoracic surgery, specifically in cases like mine?

  3. How will ECLS affect my recovery time and overall recovery process?

  4. Are there any alternative treatment options to using ECLS in my thoracic surgery?

  5. What are the potential complications or side effects of using ECLS during thoracic surgery?

  6. How experienced is the surgical team in using ECLS during thoracic surgeries?

  7. Will I need any additional monitoring or follow-up care after the surgery if ECLS is used?

  8. How will ECLS impact my overall prognosis and long-term outcomes after thoracic surgery?

  9. What should I expect during the ECLS process and how can I prepare for it?

  10. Are there any specific lifestyle changes or precautions I should take after undergoing thoracic surgery with ECLS?

Reference

Authors: Lischke R, Burkert J. Journal: Rozhl Chir. 2020 Fall;99(10):420-426. PMID: 33242959