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Perioperative Care (Pre-op, Intra-op, Post-op)
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Ca Lung |
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Diagnosis |
Consent |
Plan |
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History |
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Major and minor |
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Surgery or conservative |
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Examination |
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Nature and risk |
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Diagnostic |
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Investigation |
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Prognosis |
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Radiotherapy/chemotherapy (Palliative or adjuvant) |
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Preoperative fitness |
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Stop smoking | ¡@ | |
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Bronchodilators | ¡@ | |
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Pre-op physiotherapy | ¡@ | |
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Control of underlying medical diseases | ¡@ | |
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Weight reduction / nutritional support | ¡@ | |
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Pre-op pulmonary rehabilitation: | ¡@ | |
| ¡@ | ¡@ | Graded and measurable supervised exercise over 3 to 4 weeks, accompanied by bronchiodialtor therapy and antibiotics when pathogenic organisms are identified in sputum | ||
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Nature of operation |
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Date |
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Anaesthesia |
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Consent |
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Fast after mid-night |
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Premedication by anaesthetist |
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X match of blood | |
| ¡@ | Usually | 1 pint for pleurodesis |
| ¡@ | ¡@ | 2 pints for lobectomy / pneumonectomy |
| ¡@ | ¡@ | 3-4 pints for decortication |
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Antibiotics | |
| ¡@ | - Reducing incidence of wound infection, may not affect the incidence of pneumonia or empyema | |
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Others: | |
| ¡@ | - chest drains bottles, Foley catheters, and Ryles tube | |
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Double lumen tube |
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Lateral position |
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Posterolateral thoracotomy |
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Lateral thoracotomy |
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VATS |
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Median sternotomy |
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Mediastinoscopy/mediastinotomy for staging |