RT Book, Section
A1 Cuadrado, Daniel G.
A1 Leacche, Marzia
A1 Lambright, Eric S.
A1 Byrne, John G.
A2 Sugarbaker, David J.
A2 Bueno, Raphael
A2 Colson, Yolonda L.
A2 Jaklitsch, Michael T.
A2 Krasna, Mark J.
A2 Mentzer, Steven J.
A2 Williams, Marcia
A2 Adams, Ann
SR Print(0)
ID 1105842864
T1 Cardiopulmonary Bypass for Extended Thoracic Resections
T2 Adult Chest Surgery, 2e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 978-0-07-178189-3
LK accesssurgery.mhmedical.com/content.aspx?aid=1105842864
RD 2021/01/15
AB Bronchogenic  carcinoma  remains  the  most  common  cause  of  cancer  death  in  both  men  and  women  in  the  United  States.  These  tumors  can  exhibit  local  progression  and  invasion  before  metastatic  spread  has  occurred,  which  does  not  preclude  resection  with  curative  intent.  Any  contiguous  structure  within  the  chest  may  be  involved,  with  chest  wall  involvement  being  the  most  common.  Other  potential  sites  of  local  invasion  include  the  left  atrium,  aorta,  superior  vena  cava,  vertebral  bodies,  diaphragm,  and  esophagus.  The  increased  potential  for  morbidity  and  mortality  are  well  documented  for  these  complex  extended  resections,  making  appropriate  patient  selection  crucial.  Long-term  prognosis  depends  on  accurate  pretreatment  staging  to  assist  in  selection  of  therapy  and  complete  resection.  Cardiopulmonary  bypass  (CPB)  may  be  necessary  to  allow  surgical  resection  of  central,  locally  advanced  malignancies  because  they  involve,  or  are  close  to,  the  heart  and/or  the  great  vessels.  CPB  serves  as  an  alternative  to  conventional  ventilation  during  extended  resections  providing  oxygenation  and  hemodynamic  support.  This  chapter  will  review  the  role  of  CPB  for  the  extended  resection  of  lung  cancer,  as  well  as  the  clinical  and  technical  considerations  and  expected  surgical  outcomes.