Difference between revisions of "Ivor Lewis esophagectomy"
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=== Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> === | === Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. --> === | ||
* Arterial line +/- flowtrack | * Arterial line +/- flowtrack (ideally on left arm) | ||
* Fluid warmer | * Fluid warmer | ||
* Double-lumen tube | * Double-lumen tube (left) | ||
=== Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> === | === Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. --> === | ||
| Line 64: | Line 64: | ||
=== Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> === | === Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> === | ||
* May consider RSI if high-aspiration risk due to esophageal tumor obstructing food passage | |||
* Left sided double lumen tube | |||
=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> === | === Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> === | ||
* Start in supine position if EGD is used | |||
* Patient will be later positioned to left lateral decubitus | |||
=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> === | === Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> === | ||
| Line 74: | Line 80: | ||
=== Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> === | === Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> === | ||
* Post-op ICU | |||
=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> === | === Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> === | ||
Revision as of 10:46, 1 September 2021
Ivor Lewis esophagectomy
| Anesthesia type |
General |
|---|---|
| Airway |
DLT |
| Lines and access |
Large PIV, arterial line, NG tube |
| Monitors |
Standard, arterial line |
| Primary anesthetic considerations | |
| Preoperative | |
| Intraoperative | |
| Postoperative | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
Provide a brief summary of this surgical procedure and its indications here.
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Neurologic | |
| Cardiovascular | |
| Respiratory | |
| Gastrointestinal | |
| Hematologic | |
| Renal | |
| Endocrine | |
| Other |
Labs and studies
Operating room setup
- Arterial line +/- flowtrack (ideally on left arm)
- Fluid warmer
- Double-lumen tube (left)
Patient preparation and premedication
Regional and neuraxial techniques
Intraoperative management
Monitoring and access
- Invasive hemodynamic monitoring
- Large bore IV access
Induction and airway management
- May consider RSI if high-aspiration risk due to esophageal tumor obstructing food passage
- Left sided double lumen tube
Positioning
- Start in supine position if EGD is used
- Patient will be later positioned to left lateral decubitus
Maintenance and surgical considerations
Emergence
Postoperative management
Disposition
- Post-op ICU
Pain management
- Epidural
Potential complications
Procedure variants
| Open | Laparoscopic | Robotic | |
|---|---|---|---|
| Unique considerations | |||
| Position | |||
| Surgical time | |||
| EBL | |||
| Postoperative disposition | |||
| Pain management | |||
| Potential complications |
References
Top contributors: Nirav Kamdar and Olivia Sutton