This book 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. The chapters contain both evidence-based recommendations and descriptions of surgeons' personal practices. Chapters are organized around clearly identified recommendations, making possible the identification of useful material at a glance. Over 50 different topics are presented. This book is a valuable reference source for practicing surgeons, surgeons in training, and educators.
BACKGROUND: Introduction.- Evidence-Based Medicine: Levels of Evidence and Grades of Recommendation.- Decision Analytic Techniques.- Non-Clinical Components of Surgical Decision Making.- How Patients Make Decisions with their Surgeons: The Role of Counseling and Patient Decision Aids.- LUNG: Radiographic Staging of Lung Cancer: Computed Tomography (CT) and Positron Emission Tomography (PET) .- Routine Mediastinoscopy for Clinical Stage I Lung Cancer.- Management of Unexpected N2 Disease Discovered at Thoracotomy.- Induction Therapy for Clinical Stage I Lung Cancer.- Induction Therapy for Stage IIIA (N2) Lung Cancer.- Adjuvant postoperative therapy for completely resected stage I lung cancer.- Sleeve Lobectomy vs. Pneumonectomy for Lung Cancer Patients with Good Pulmonary Function.- Lesser Resection Versus Lobectomy for Stage I Lung Cancer in Patients with Good Pulmonary Function.-. Lesser Resection vs RT for Patients with Compromised Lung Function and STAGE I Lung Cancer.- Resection for Patients Initially Diagnosed with N3 Lung Cancer after Response to Induction Therapy.- VATS Major Lung Resections.- Surgery for Non-Small Cell Lung Cancer with Solitary M1 Disease.- Thoracoscopy Versus the Open Approach for Resection of Solitary Pulmonary Metastases.- Unilateral or bilateral approach for unilateral pulmonary metastatic disease.- Surgery for Bronchoalveolar Lung Cancer.- LVRS in the Candidate for Lung Transplantation.- Pleural Sclerosis for the Management of Initial Pneumothorax.- ESOPHAGUS: Staging for Esophageal Cancer: PET, EUS.- Induction Therapy for Resectable Esophageal Cancer.- Transthoracic versus Transhiatal Resection for Carcinoma of the Esophagus.- Minimally Invasive vs Open Esophagectomy for Cancer.- Lymph Node Dissection for Carcinoma of the Esophagus.- Intrathoracic vs Cervical Anastomosis in Esophageal Replacement.- Jejunostomy after Esophagectomy.- Gastric Emptying Procedures after Esophagectomy.- Posterior Mediastinal or Retrosternal Reconstruction Following Esophagectomy for Cancer.- Postoperative adjuvant therapy for completely resected esophageal cancer.- Celiac Lymph Nodes and Esophageal Cancer.- Partial or Total Fundoplication for GERD in the Presence of Impaired Esophageal Motility.- Botox, Balloon or Myotomy: Optimal treatment for Achalasia.- Fundoplication after Laparoscopic Myotomy for Achalasia.- Primary Repair for Delayed Recognition of Esophageal Perforation.- Lengthening Gastroplasty for Managing GERD and Stricture.- Lengthening Gastroplasty for Managing Giant Paraesophageal Hernia.- Evidenced-Based Management of Zenker's Diverticulum: Open Versus Transoral Approaches.- Management of Minimally Symptomatic Pulsion Diverticula of the Esophagus.- DIAPHRAGM: Giant Paraesophageal Hernia: Thoracic, Open Abdominal, or Laparoscopic Approach.- Management of Minimaly Symptomatic Giant Paraesophageal Hernias.- Plication for Diaphragmatic Eventration.- Pacing for Unilateral Diaphragm Paralysis.- Optimal Crural Closure Techniques for Repair of Large Hiatal Hernias.- Management of Acute Diaphragmatic Rupture: Thoracotomy versus Laparotomy.- AIRWAY: Stenting for Benign Airway Obstruction.- Tracheal Resection for Thyroid or Esophageal Cancer.- PLEURA AND PLEURAL SPACE: Pleural Sclerosis for Malignant Pleural Effusion: Optimal Sclerosing Agent.- Management of Malignant Pleural Effusion: Sclerosis or Chronic Tube drainage.- Initial Spontaneous Pneumothorax: The Role of Thoracoscopic Therapy.- Intrapleural Fibrinolytics.- Diffuse Malignant Pleural Mesothelioma: The Role of Pleurectomy.- Treatment of Malignant Pleural Mesothelioma: Is There a Benefit to Pleuropneumonectomy?.- MEDIASTINUM: Management of Myasthenia Gravis: Does Thymectomy Provide Benefit over Medical Therapy.- Thymectomy for Myathenias Gravis.- Management of Residual Disease after Therapy for Mediastinal Germ Cell Tumor and Normal Serum Markers.- Management of Malignant Pericardial Effusions.- Asymptomatic Pericardial Cyst: Observe or Resect.- CHEST WALL: Optimal Approach to TOS: Transaxillary, Supraclavicular, or Infraclavicular.- Pectus Excavatum in Adults.