Difficult Decisions in Thoracic Surgery: An Evidence-Based Approach PDF
Preview Difficult Decisions in Thoracic Surgery: An Evidence-Based Approach
Difficult Decisions in Thoracic Surgery Mark K. Ferguson, Ed. Difficult Decisions in Thoracic Surgery An Evidence-Based Approach Mark K. Ferguson, MD Professor, Department of Surgery The University of Chicago Head, Thoracic Surgery Service The University of Chicago Hospitals Chicago, IL, USA British Library Cataloguing in Publication Data Diffi cult decisions in thoracic surgery 1. Chest — Surgery — Decision making 2. Chest — surgery I. Ferguson, Mark K. 617.5′4 ISBN-13: 9781846283840 ISBN-10: 1846283841 Library of Congress Control Number: 2006926462 ISBN-10: 1-84628-384-1 e-ISBN 1-84628-470-0 Printed on acid-free paper ISBN-13: 978-1-84628-384-0 © Springer-Verlag London Limited 2007 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permit- ted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms of licences issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers. The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant laws and regulations and therefore free for general use. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. 9 8 7 6 5 4 3 2 1 springer.com To Phyllis, a decision that has withstood the test of time. Preface Why do thoracic surgeons need training in decision making? Many of us who have weathered harrowing residencies in surgery feel that, after such experiences, decision making is a natural extension of our selves. While this is no doubt true, correct deci- sion making is something that many of us have yet to master. The impetus to develop a text on evidence-based decision making in thoracic surgery was stimulated by a conference for cardiothoracic surgical trainees developed in 2004 and sponsored by the American College of Chest Physicians. During that conference it became clear that we as thoracic surgeons are operating from a very limited fund of true evidence-based information. What was also clear was the fact that many of the decisions we make in our everyday practices are not only uninformed by evidence-based medicine, but often are contradictory to existing guidelines or evidence-based recommendations. The objectives of this book are to explain the process of decision making, both on the part of the physician and on the part of the patient, and to discuss specifi c clinical problems in thoracic surgery and provide recommendations regarding their manage- ment using evidence-based methodology. Producing a text that will purportedly guide experienced, practicing surgeons in the decision-making process that they are accus- tomed to observe on a daily basis is a daunting task. To accomplish this it was necessary to assemble a veritable army of authors who are widely considered to be experts in their fi elds. They were given the unusual (to many of them) task of critically evaluating evi- dence on a well-defi ned topic and provide two opinions regarding appropriate manage- ment of their topic: one based solely on the existing evidence, and another based on their prevailing practice, clinical experience, and teaching. Most authors found this to be an excellent learning experience. It is hoped that the readers of this book will be similarly enlightened by its contents. How should a practicing surgeon use this text? As is mentioned in the book, wholesale adoption of the stated recommendations will serve neither physician nor patient well. The reader is asked to critically examine the material presented, assess it in the light of his or her own practice, and integrate the recommendations that are appropriate. The reader must have the understanding that surgery is a complex, individualized, and rapidly evolv- ing specialty. Recommendations made today for one patient may not be appropriate for that same patient in the same situation several years hence. Similarly, one recommenda- tion will not serve all patients well. The surgeon must use judgment and experience to adequately utilize the guidelines and recommendations presented herein. To produce a text with timely recommendations about clinical situations in a world of rapidly evolving technology and information requires that the editor, authors, and vii viii Preface publisher work in concert to provide a work that is relevant and up-to-date. To this end I am grateful to the authors for producing their chapters in an extraordinarily timely fashion. My special thanks go to Melissa Morton, Senior Editor at Springer, for her rapid processing and approval of the request to develop this book, and to Eva Senior, Senior Editorial Assistant at Springer, for her tireless work in keeping us all on schedule. My thanks go to Kevin Roggin, MD, for sharing the T.S. Eliot lines and the addendum to them. Finally, the residents with whom I have had the opportunity and privilege to work during the past two decades continually reinforce the conviction that quality information is the key to improved patient care and outcomes. Mark K. Ferguson, MD 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 Légaré, 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. ix 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
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