ABSTRACT
This chapter discusses thoracic surgeries. It also explains preoperative assessment and investigations, preoperative preparation, premedication, monitoring, anaesthetic technique, postoperative management. These surgeries include bronchopleural fistula, anaesthesia for thoracic surgery, lobectomy, mediastinal surgery, pleurectomy and pleurodesis, pneumonectomy, postoperative analgesia and rigid bronchoscopy. Bronchopleural fistula is a direct communication between the tracheobronchial tree and the pleural cavity. Foreign bodies can be inhaled at any age but are more common in children under 3, the elderly, debilitated and inebriated patients. Foreign bodies in the tracheobronchial tree require removal by bronchoscopy. Lobectomy is the surgical excision of one lung lobe. Mediastinoscopy and mediastinotomy procedures are used to assess mediastinal lymph node involvement to stage carcinoma, during which samples are often taken. Pleurectomy is removal of the parietal pleura. It is the treatment of choice for fit patients with a spontaneous pneumothorax. The pleura is stripped except over the diaphragmatic and mediastinal surfaces of the lung which then adheres to the chest wall.
