Our Summary

The paper discusses the best time for referring patients for surgical consultations before operations related to the chest, and how to best handle any existing health issues that could complicate these surgeries. These types of surgeries can often be complicated to manage both during and after the procedure, especially during the current COVID-19 pandemic.

However, adequate preparation before the surgery can help identify any health issues the patient may have, allowing doctors to reduce the risks associated with the surgery. This kind of preparation often requires a team of medical professionals. The authors suggest that patients can benefit from early involvement with a dedicated clinic that specializes in preparing patients for complex surgeries.

While preparing patients for chest-related surgery can be a tough task for any healthcare system, following proven guidelines can help improve patient care and reduce risks. As surgical techniques continue to advance, more research is needed to ensure that care before, during, and after surgery continues to improve.

FAQs

  1. What is the importance of preoperative optimization in thoracic surgery?
  2. How has the SARS-CoV-2 pandemic affected patients requiring thoracic surgeries?
  3. What are some of the challenges in optimizing patients for thoracic surgery in both small and large health systems?

Doctor’s Tip

One helpful tip a doctor might tell a patient about thoracic surgery is to ensure they engage with a dedicated preoperative clinic experienced in caring for complex surgical patients. This can help in optimizing the patient for surgery, managing comorbidities, and mitigating surgical risks. By following evidence-based guidelines and engaging in multidisciplinary care, patients can improve their outcomes and ensure a successful surgical experience.

Suitable For

Patients who are typically recommended for thoracic surgery may include those with:

  1. Lung cancer
  2. Esophageal cancer
  3. Chest wall tumors
  4. Pleural diseases (such as pleural effusion or pleural mesothelioma)
  5. Thoracic outlet syndrome
  6. Mediastinal tumors
  7. Congenital chest wall deformities
  8. Lung infections (such as empyema)
  9. Thoracic trauma
  10. Severe gastroesophageal reflux disease

It is important for patients with these conditions to be evaluated by a multidisciplinary team, including thoracic surgeons, pulmonologists, oncologists, and other specialists, to determine the most appropriate treatment plan and optimize the patient’s overall health before undergoing surgery.

Timeline

Before thoracic surgery:

  • Patient is referred for perioperative surgical consultation
  • Preoperative optimization to identify and manage comorbidities
  • Multidisciplinary planning for surgical risks
  • Engagement of a dedicated preoperative clinic for complex surgical patients

After thoracic surgery:

  • Postoperative management for challenging cases
  • Mitigation of surgical risks through evidence-based guidelines
  • Continued monitoring and care for optimal recovery
  • Future research needed to improve perioperative care as surgical techniques evolve

What to Ask Your Doctor

Some questions a patient should ask their doctor about thoracic surgery may include:

  1. What specific type of thoracic surgery do I need and why?
  2. What are the potential risks and complications associated with this type of surgery?
  3. How should I prepare for surgery, both physically and mentally?
  4. What is the expected recovery time and what can I expect in terms of pain management?
  5. Are there any alternative treatment options to consider before proceeding with surgery?
  6. Will I need any additional tests or consultations before the surgery?
  7. What is the experience of the surgical team in performing this type of procedure?
  8. What are the success rates for this type of surgery and what is the long-term outlook for recovery?
  9. Are there any specific lifestyle changes or follow-up care instructions I should be aware of after surgery?
  10. How can I best communicate with my healthcare team throughout the surgical process?

Reference

Authors: Coleman JR, Hanson NA. Journal: Curr Opin Anaesthesiol. 2023 Feb 1;36(1):68-73. doi: 10.1097/ACO.0000000000001215. Epub 2022 Nov 24. PMID: 36550607