TY - CHAP M1 - Book, Section TI - Cardiopulmonary Bypass for Extended Thoracic Resections A1 - Blasberg, Justin D. A1 - Boffa, Daniel J. A2 - Sugarbaker, David J. A2 - Bueno, Raphael A2 - Burt, Bryan M. A2 - Groth, Shawn S. A2 - Loor, Gabriel A2 - Wolf, Andrea S. A2 - Williams, Marcia A2 - Adams, Ann PY - 2020 T2 - Sugarbaker’s Adult Chest Surgery, 3e AB - To completely resect a primary lung cancer that extends through the visceral pleura into a neighboring structure, the pulmonary and extrapulmonary portions of that tumor must be removed as a single specimen (“en bloc”). Most locally invasive tumors are amenable to en bloc resection, including cancers that involve the chest wall, vertebral bodies, or diaphragm. A subset of extended tumor resections for T4 disease, such as those in proximity to the heart or central vasculature, may be facilitated using cardiopulmonary bypass (CPB). CPB can make surgery easier (by decompressing the heart and creating more space in the surgical field), and some reconstructions are not technically possible without it (i.e., tumor invasion of the main pulmonary artery [PA]). The use of CPB also has some negative considerations such as requirements for anticoagulation, potential for tumor dissemination, and technical considerations associated with cannulation. More specifically, CPB is associated with prolonged anesthesia, longer operations, and risk for cardiovascular and pulmonary complications.1–4 Therefore, we reserve the use of CPB for those cases that absolutely cannot be performed without it. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accesssurgery.mhmedical.com/content.aspx?aid=1170410973 ER -