Difficult Decisions in Thoracic Surgery: An Evidence-Based Approach (Hardcover)

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Difficult Decisions in Thoracic Surgery: An Evidence-Based Approach describes the recommended ideal approach, rather
than customary care, in selected clinical situations. Brief chapters are devoted to a specific question or decision in
general thoracic surgery that is difficult or controversial. Although some of the content may be available in major
thoracic texts, rarely are such questions posed specifically and analyzed according to the level of supporting evidence
available. The chapters contain both evidence-based recommendations and descriptions of surgeons’ personal practices
based on their experience and the published literature.

Chapters are organized around clearly identified recommendations, making possible the identification of useful material
at a glance. Over 50 different topics are presented, including a review of available evidence and a general discussion
of recommended practice.

This book is a valuable reference source for practicing surgeons, surgeons in training, and educators.

ix
Contents
Preface . . . . . . vii
Contributors . xv
Part 1 Background
1 Introduction . . . . . . . . . . . . . . . . 3
Mark K. Ferguson
2 Evidence-Based Medicine: Levels of Evidence and Grades of
Recommendation . . . . . . . . . . . . 13
Andrew J. Graham and Sean C. Grondin
3 Decision Analytic Techniques . 21
Anirban Basu and Amy G. Lehman
4 Nonclinical Components of Surgical Decision Making . . . . . . . . . . . . . . . . . 36
Jo Ann Broeckel Elrod, Farhood Farjah, and David R. Flum
5 How Patients Make Decisions with Their Surgeons: The Role of
Counseling and Patient Decision Aids . . . . . . . . . . . . 44
Annette M. O’Connor, France Legare, and Dawn Stacey
Part 2 Lung
6 Radiographic Staging of Lung Cancer: Computed Tomography and
Positron Emission Tomography . . . . . . . . . . . . . . . . . . 59
Frank C. Detterbeck
7 Routine Mediastinoscopy for Clinical Stage I Lung Cancer . . . . . . . . . . . . . 68
Karl Fabian L. Uy and Thomas K. Waddell
8 Management of Unexpected N2 Disease Discovered at Thoracotomy . . . . . 75
Hyde M. Russell and Mark K. Ferguson
9 Induction Therapy for Clinical Stage I Lung Cancer 82
David C. White and Thomas A. D’Amico
10 Induction Therapy for Stage IIIA (N2) Lung Cancer 88
Shari L. Meyerson and David H. Harpole, Jr.
x Contents
11 Adjuvant Postoperative Therapy for Completely Resected Stage I
Lung Cancer . . . . . . . . . . . . . . . . 94
Thomas A. D’Amato and Rodney J. Landreneau
12 Sleeve Lobectomy Versus Pneumonectomy for Lung Cancer Patients
with Good Pulmonary Function . . . . . . . . . . . . . . . . . . 103
Lisa Spiguel and Mark K. Ferguson
13 Lesser Resection Versus Lobectomy for Stage I Lung Cancer in Patients
with Good Pulmonary Function . . . . . . . . . . . . . . . . . . 110
Anthony W. Kim and William H. Warren
14 Lesser Resection Versus Radiotherapy for Patients with Compromised
Lung Function and Stage I Lung Cancer . . . . . . . . . . . 119
Jeffrey A. Bogart and Leslie J. Kohman
15 Resection for Patients Initially Diagnosed with N3 Lung Cancer after
Response to Induction Therapy . . . . . . . . . . . . . . . . . . 128
Antonio D’Andrilli, Federico Venuta, and Erino A. Rendina
16 Video-Assisted Thorascopic Surgery Major Lung Resections . . . . . . . . . . . 140
Raja M. Flores and Naveed Z. Alam
17 Surgery for Non-Small Cell Lung Cancer with Solitary M1 Disease . . . . . . 147
Robert J. Downey
18 Thoracoscopy Versus the Open Approach for Resection of Solitary
Pulmonary Metastases . . . . . . . 151
Keith S. Naunheim
19 Unilateral or Bilateral Approach for Unilateral Pulmonary
Metastatic Disease . . . . . . . . . . . 158
Ashish Patel and Malcolm M. DeCamp, Jr.
20 Surgery for Bronchoalveolar Lung Cancer . . . . . . . . . 165
Subrato J. Deb and Claude Deschamps
21 Lung Volume Reduction Surgery in the Candidate
for Lung Transplantation . . . . . 175
Christine L. Lau and Bryan F. Meyers
22 Pleural Sclerosis for the Management of Initial Pneumothorax . . . . . . . . . 186
Richard W. Light
Part 3 Esophagus
23 Staging for Esophageal Cancer: Positron Emission Tomography,
Endoscopic Ultrasonography . 195
Jarmo A. Salo
24 Induction Therapy for Resectable Esophageal Cancer . . . . . . . . . . . . . . . . . . 200
Sarah E. Greer, Philip P. Goodney, and John E. Sutton
25 Transthoracic Versus Transhiatal Resection for Carcinoma
of the Esophagus . . . . . . . . . . . . 208
Jan B.F. Hulscher and J. Jan B. van Lanschot
Contents xi
26 Minimally Invasive Versus Open Esophagectomy for Cancer . . . . . . . . . . . 218
Ara Ketchedjian and Hiran Fernando
27 Lymph Node Dissection for Carcinoma of the Esophagus . . . . . . . . . . . . . . 225
Nasser K. Altorki
28 Intrathoracic Versus Cervical Anastomosis in
Esophageal Replacement . . . . . 234
Christian A. Gutschow and Jean-Marie Collard
29 Jejunostomy after Esophagectomy . . . . . . . . . . . . . . . . 242
Lindsey A. Clemson, Christine Fisher, Terrell A. Singleton, and
Joseph B. Zwischenberger
30 Gastric Emptying Procedures after Esophagectomy 250
Jeffrey A. Hagen and Christian G. Peyre
31 Posterior Mediastinal or Retrosternal Reconstruction Following
Esophagectomy for Cancer . . . 258
Lara J. Williams and Alan G. Casson
32 Postoperative Adjuvant Therapy for Completely Resected
Esophageal Cancer . . . . . . . . . . 265
Nobutoshi Ando
33 Celiac Lymph Nodes and Esophageal Cancer . . . . . . 271
Thomas W. Rice and Daniel J. Boffa
34 Partial or Total Fundoplication for Gastroesophagael Refl ux Disease
in the Presence of Impaired Esophageal Motility . . . 279
Jedediah A. Kaufman and Brant K. Oelschlager
35 Botox, Balloon, or Myotomy: Optimal Treatment for Achalasia . . . . . . . . . 285
Lee L. Swanstrom and Michelle D. Taylor
36 Fundoplication after Laparoscopic Myotomy for Achalasia . . . . . . . . . . . . . 292
Fernando A. Herbella and Marco G. Patti
37 Primary Repair for Delayed Recognition of Esophageal Perforation . . . . . 298
Cameron D. Wright
38 Lengthening Gastroplasty for Managing Gastroesophagael Refl ux
Disease and Stricture . . . . . . . . 305
Sandro Mattioli and Maria Luisa Lugaresi
39 Lengthening Gastroplasty for Managing Giant
Paraesophageal Hernia . . . . . . . 318
Kalpaj R. Parekh and Mark D. Iannettoni
40 Management of Zenker’s Diverticulum: Open Versus
Transoral Approaches . . . . . . . . 323
Douglas E. Paull and Alex G. Little
41 Management of Minimally Symptomatic Pulsion Diverticula
of the Esophagus . . . . . . . . . . . . 332
Giovanni Zaninotto and Giuseppe Portale
xii Contents
Part 4 Diaphragm
42 Giant Paraesophageal Hernia: Thoracic, Open Abdominal, or
Laparoscopic Approach . . . . . . 343
Glenda G. Callender and Mark K. Ferguson
43 Management of Minimally Symptomatic Giant
Paraesophageal Hernias . . . . . . 350
David W. Rattner and Nathaniel R. Evans
44 Plication for Diaphragmatic Eventration . . . . . . . . . . 356
Marco Alifano
45 Pacing for Unilateral Diaphragm Paralysis . . . . . . . . 365
Raymond P. Onders
46 Optimal Crural Closure Techniques for Repair of Large
Hiatal Hernias . . . . . . . . . . . . . . 371
Carlos A. Galvani and Santiago Horgan
47 Management of Acute Diaphragmatic Rupture: Thoracotomy
Versus Laparotomy . . . . . . . . . . 379
Seth D. Force
Part 5 Airway
48 Stenting for Benign Airway Obstruction . . . . . . . . . . 387
Loay Kabbani and Tracey L. Weigel
49 Tracheal Resection for Thyroid or Esophageal Cancer . . . . . . . . . . . . . . . . . 398
Todd S. Weiser and Douglas J. Mathisen
Part 6 Pleura and Pleural Space
50 Pleural Sclerosis for Malignant Pleural Effusion:
Optimal Sclerosing Agent . . . . 409
Zane T. Hammoud and Kenneth A. Kesler
51 Management of Malignant Pleural Effusion: Sclerosis or Chronic
Tube Drainage . . . . . . . . . . . . . . 414
Joe B. Putnam, Jr.
52 Initial Spontaneous Pneumothorax: Role of Thoracoscopic Therapy . . . . . 424
Faiz Y. Bhora and Joseph B. Shrager
53 Intrapleural Fibrinolytics . . . . . 433
Jay T. Heidecker and Steven A. Sahn
54 Diffuse Malignant Pleural Mesothelioma: The Role of Pleurectomy . . . . . 442
Jasleen Kukreja and David M. Jablons
55 Treatment of Malignant Pleural Mesothelioma: Is There
a Benefi t to Pleuropneumonectomy? . . . . . . . . . . . . . . 451
Stacey Su, Michael T. Jaklitsch, and David J. Sugarbaker
Contents xiii
Part 7 Mediastinum
56 Management of Myasthenia Gravis: Does Thymectomy Provide
Benefi t over Medical Therapy Alone? . . . . . . . . . . . . . 463
Vera Bril and Shaf Keshavjee
57 Thymectomy for Myasthenia Gravis: Optimal Approach . . . . . . . . . . . . . . . 469
Joshua R. Sonett
58 Management of Residual Disease after Therapy for Mediastinal Germ
Cell Tumor and Normal Serum Markers . . . . . . . . . . 474
Luis J. Herrera and Garrett L. Walsh
59 Management of Malignant Pericardial Effusions . . . 482
Nirmal K. Veeramachaneni and Richard J. Battafarano
60 Asymptomatic Pericardial Cyst: Observe or Resect? 488
Robert J. Korst
Part 8 Chest Wall
61 Optimal Approach to Thoracic Outlet Syndrome: Transaxillary,
Supraclavicular, or Infraclavicular . . . . . . . . . . . . . . . . 495
Richard J. Sanders
62 Pectus Excavatum in Adults . . 503
Charles B. Huddleston
Index . . . . . . . . 509