Contents

Prolog

Authors and contributors

1. Anesthesia and analgesia for thoracic surgery

1.1 Introduction

1.2 Anesthesia for pediatric thoracic surgery

1.2.1 Neurotoxicity of anesthesia in neonates, infants and young children

1.2.2 Basic anesthetic techniques in pediatric anesthesia

1.2.3 Age at and timing of surgery

1.2.4 Preoperative evaluation and workup

1.2.5 Intraoperative monitoring

1.2.6 Lung isolation and one lung ventilation in children

1.2.7 Anesthetic implications for specific disorders

1.3 Perioperative pain management

1.3.1 Systemic analgesia

1.3.2 Local-regional anesthesia

1.4 Further reading

2. Approaches to the thoracic cavity

2.1 Introduction

2.2 Thoracotomy

2.2.1 Anterior thoracotomy

2.2.2 Posterolateral thoracotomy

2.2.3 Lateral muscle sparing thoracotomy (anterolateral/anteroaxillary thoracotomy)

2.2.4 Closure of the thoracotomy with regard to postoperative pain

2.3 Sternotomy

2.3.1 Median sternotomy

2.3.2 Partial median sternotomy (hemisternotomy, upper sternotomy)

2.3.3 Closure of the sternotomy

2.3.4 Extended approaches

2.4 Video-assisted thoracoscopic surgery (VATS): Development of the operative technique

2.4.1 Introduction

2.4.2 Ventilatory and pathophysiological considerations for VATS

2.4.3 Equipment

2.4.4 Positioning of the patient and trocar introduction

2.4.5 Indications, pros and cons for pediatric VATS

2.5 Bronchoscopy

2.5.1 Introduction

2.5.2 Bronchoscopes

2.5.3 Sedation and anesthesia

2.5.4 Diagnostic procedures

2.6 Further reading

3. Bronchopulmonary diseases

3.1 Introduction

3.2 Congenital thoracic malformations

3.2.1 Congenital cystic adenomatoid malformation (CCAM)

3.2.2 Sequestration

3.2.3 Congenital lobar and segmental emphysema

3.2.4 Bronchogenic and foregut duplication cysts

3.2.5 VATS in congenital thoracic malformations

3.3 Airway diseases

3.3.1 Introduction

3.3.2 Laryngotracheal reconstruction

3.3.3 Tracheostomy

3.4 Further reading

4. Lung transplantation

4.1 Introduction

4.2 General considerations

4.3 Indications

4.4 Allocation and size matching

4.5 Surgical technique and lobar transplantation

4.6 Living donation

4.7 Extracorporeal support

4.8 Outcome

4.9 Retransplantation

4.10 Summary

4.11 Further reading

5. Tumors in childhood and adolescence

5.1 Introduction

5.2 Primary lung tumors in childhood and adolescence

5.2.1 General considerations

5.2.2 Bronchial carcinoid tumor

5.2.3 Mucoepidermoid carcinoma of the bronchus

5.2.4 Adenoid cystic carcinoma

5.2.5 Pulmonary blastoma

5.2.6 Bronchioloalveolar carcinoma/adenocarcinoma in situ

5.2.7 Hemangiopericytoma

5.2.8 Inflammatory myofibroblastic tumors

5.2.9 Pulmonary arteriovenous malformations

5.2.10 Hamartoma

5.2.11 Juvenile respiratory papillomatosis

5.3 Chest wall tumors in childhood and adolescence

5.3.1 General considerations

5.3.2 Primitive neuroectodermal tumors (PNETs)

5.3.3 Rhabdomyosarcoma

5.3.4 Osteosarcoma/malignant fibrohistiocytoma

5.3.5 Fibrosarcoma

5.3.6 Hemangiopericytoma

5.3.7 Langerhans cell histiocytosis (LCH)

5.3.8 Lipoblastoma

5.3.9 Mesenchymal hamartoma

5.3.10 Chondroma

5.3.11 Desmoid tumor

5.4 Primary mediastinal tumors in childhood and adolescence

5.4.1 General considerations

5.4.2 Lymphoma

5.4.3 Extragonadal germ cell tumors

5.4.4 Thymoma and thymic carcinoma

5.4.5 Neurogenic tumors

5.5 Further reading

6. Diaphragm

6.1 Introduction

6.2 Congenital diaphragmatic hernia (CDH)

6.2.1 Introduction

6.2.2 Epidemiology of CDH

6.2.3 Pathophysiology of CDH

6.2.4 Prenatal diagnosis

6.2.5 Treatment

6.2.6 Surgical therapy

6.2.7 Long-term follow-up

6.2.8 Implications and future perspectives

6.3 Eventration

6.3.1 Introduction – definition

6.3.2 Etiology, physiopathology

6.3.3 Clinical presentation

6.3.4 Paraclinical investigation

6.3.5 Treatment

6.3.6 Follow-up

6.4 Further reading

7. Thoracic wall

7.1 Introduction

7.2 Pectus excavatum

7.2.1 Indication

7.2.2 Preoperative evaluation

7.2.3 Technique

7.2.4 Postoperative care and follow up

7.2.5 Complications

7.2.6 Removal of the bar(s)

7.3 Pectus carinatum

7.4 Miscellaneous

7.4.1 Poland syndrome

7.4.2 Jeune syndrome

7.4.3 Sternal defects

7.4.4 Defects of the thoracic wall

7.5 Trauma

7.5.1 Introduction

7.5.2 Biomechanics and anatomy

7.5.3 General evaluation and initial management of the child with chest injuries

7.5.4 Airway obstruction

7.5.5 Traumatic asphyxia

7.5.6 Chest wall injuries

7.5.7 Pulmonary injuries

7.5.8 Tracheobronchial injuries

7.5.9 Esophageal injuries

7.5.10 Diaphragmatic injuries

7.5.11 Great vessel injuries

7.5.12 Heart and pericardium

7.5.13 Resuscitative thoracotomy

7.5.14 Pitfalls in pediatric thoracic trauma

7.5.15 Conclusion

7.6 Further reading

8. Miscellaneous infection

8.1 Introduction

8.2 Empyema (including lung abcess)

8.3 Echinococcosis

8.3.1 Introduction

8.3.2 Cystic echinococcosis

8.3.3 Alveolar echinococcosis

8.4 Chylothorax in neonates

8.5 Aquired chylothorax

8.6 Thymus

8.7 Hyperhydrosis

8.7.1 Introduction

8.7.2 Clinical management

8.7.3 Surgical treatment

8.7.4 Conclusions

8.8 Further reading

Index