RESUMEN
Primary chest wall tumors are rare and represent a challenging clinical entity. Preoperative work-up includes a thorough history, radiographic imaging, and a biopsy approach that does not make a future definitive resection more difficult. Treatment decisions are based on tumor histology, stage, local aggressiveness, and responsiveness to chemotherapy and radiation. Wide excision is the foundation of treatment of most malignant primary chest wall tumors. The role of radiation therapy in the neoadjuvant or adjuvant setting is to reduce local recurrence. The use of adjuvant chemotherapy is more controversial. For most primary chest wall malignancies, margin-negative resection remains the best chance of cure.
Asunto(s)
Hemangioma/cirugía , Neoplasias de los Tejidos Conjuntivo y Blando/cirugía , Neoplasias de la Vaina del Nervio/cirugía , Neoplasias de los Tejidos Blandos/cirugía , Neoplasias Torácicas/cirugía , Procedimientos Quirúrgicos Torácicos , Pared Torácica/cirugía , Quimioradioterapia Adyuvante , Hemangioma/diagnóstico , Hemangioma/patología , Hemangioma/terapia , Humanos , Neoplasias de los Tejidos Conjuntivo y Blando/diagnóstico , Neoplasias de los Tejidos Conjuntivo y Blando/patología , Neoplasias de los Tejidos Conjuntivo y Blando/terapia , Neoplasias de la Vaina del Nervio/diagnóstico , Neoplasias de la Vaina del Nervio/patología , Neoplasias de la Vaina del Nervio/terapia , Neoplasias de los Tejidos Blandos/diagnóstico , Neoplasias de los Tejidos Blandos/patología , Neoplasias de los Tejidos Blandos/terapia , Neoplasias Torácicas/diagnóstico , Neoplasias Torácicas/patología , Neoplasias Torácicas/terapia , Pared Torácica/diagnóstico por imagen , Pared Torácica/patologíaRESUMEN
The National Quality Forum (NQF) is a multistakeholder, nonprofit, membership-based organization improving health care through preferential use of valid performance measures. NQF-endorsed measures are considered the gold standard for health care measurement in the United States. The Society of Thoracic Surgeons is the steward of the only six NQF-endorsed general thoracic surgery measures. These measures include one structure measure (participation in a national general thoracic surgery database), two process measures (recording of clinical stage and recording performance status before lung and esophageal resections), and three outcome measures (risk-adjusted morbidity and mortality after lung and esophageal resections and risk-adjusted length of stay greater than 14 days after lobectomy).
Asunto(s)
Neoplasias Esofágicas/cirugía , Neoplasias Pulmonares/cirugía , Indicadores de Calidad de la Atención de Salud , Humanos , Evaluación de Resultado en la Atención de Salud , Procedimientos Quirúrgicos TorácicosRESUMEN
Tracheostomy, whether open or percutaneous, is a commonly performed procedure and is intended to provide long-term surgical airway for patients who are dependent on mechanical ventilatory support or require (for various reasons) an alternative airway conduit. Due to its invasive and physiologically critical nature, tracheostomy placement can be associated with significant morbidity and even mortality. This article provides a comprehensive overview of commonly encountered complications that may occur during and after the tracheal airway placement, including both short- and long-term postoperative morbidity.
RESUMEN
Needle thoracostomy (NT) is a valuable adjunct in the management of tension pneumothorax (tPTX), a life-threatening condition encountered mainly in trauma and critical care environments. Most commonly, needle thoracostomies are used in the prehospital setting and during acute trauma resuscitation to temporize the affected individuals prior to the placement of definitive tube thoracostomy (TT). Because it is both an invasive and emergent maneuver, NT can be associated with a number of potential complications, some of which may be life-threatening. Due to relatively common use of this procedure, it is important that healthcare providers are familiar, and ready to deal with, potential complications of NT.