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Delayed recovery following thoracic surgery

persistent issues and potential interventions

Pedoto, Alessiaa; Perrino, Albert C. Jrb

Current Opinion in Anesthesiology: February 2019 - Volume 32 - Issue 1 - p 3–9
doi: 10.1097/ACO.0000000000000669
THORACIC ANESTHESIA: Edited by Albert C. Perrino Jr
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Purpose of review Lung and esophageal surgery remain a curative option for resectable cancers. However, despite advances in surgical and anesthesia practices, the inclusion of patients with comorbidities that would have previously not been offered curative resection presents additional concerns and challenges.

Recent findings Perioperative complication rates remain high and prolonged and/or painful recovery are common. Further, many patients face a permanent decline in their functional status, which negatively affects their quality of life. Examination of the variables associated with high complications following thoracic surgery reveals patient, physician, and institutional factors in the forefront. Anesthesiologist training, Enhanced Recovery After Surgery protocols, and preparations to minimize “failure to rescue” when a complication does arise are key strategies to address adverse outcomes.

Summary Delayed and complicated recovery after thoracic noncardiac surgery persist in current practice. This review analyzes the diverse factors that can impact complications and quality of life after lung surgery and the interventions that can help decrease length of stay and improve return to baseline conditions.

aDepartment of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York

bDepartment of Anesthesiology, Yale School of Medicine and VA Connecticut Healthcare System, New Haven, Connecticut, USA

Correspondence to Alessia Pedoto, MD FASA, Department of Anesthesiology and Critical Care Medicine, 1275 York Ave. Room M301, New York, NY 10065, USA. Tel: +1 212 639 6840; e-mail: pedotoa@mskcc.org

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