Breast lumpectomy
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Revision as of 08:10, 16 April 2021 by Barrett Larson (talk | contribs)
Breast lumpectomy
| Anesthesia type |
GA vs. MAC |
|---|---|
| Airway |
LMA for GA |
| Lines and access |
PIV |
| Monitors |
Standard |
| Primary anesthetic considerations | |
| Preoperative | |
| Intraoperative | |
| Postoperative | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
A lumpectomy is the removal of a discrete portion or “lump” of breast tissue. This procedure is sometimes referred to as a partial mastectomy.
Sometimes the procedure involves a wire localization step, where the patient has a wire inserted into the breast tissue under fluoroscopic guidance pre-operatively. The wire is placed by a radiologist such that the tip resides in the target tissue, thus enabling the surgeon to more precisely localize the lesion. Wire localization is more often done if the lesion is deeper.
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Neurologic | |
| Cardiovascular | |
| Respiratory | |
| Gastrointestinal | |
| Hematologic | |
| Renal | |
| Endocrine | |
| Other |
Labs and studies
Operating room setup
Patient preparation and premedication
Regional and neuraxial techniques
Intraoperative management
Monitoring and access
- PIV x 1
- Place BP cuff office the surgical field
- Make sure EKG leads are not near the sterile field
Induction and airway management
Positioning
- Supine
- Arms out
Maintenance and surgical considerations
Emergence
Postoperative management
Disposition
Pain management
Potential complications
Procedure variants
| Superficial | Deep | |
|---|---|---|
| Unique considerations | More likely MAC | More likely GA |
| Position | ||
| Surgical time | 15-45 mins | 30-60 mins |
| EBL | 5-10cc | 5-10cc |
| Postoperative disposition | ||
| Pain management | ||
| Potential complications |
References
Top contributors: Barrett Larson, Chris Rishel, Tony Wang and Ashwini Bhat