Goto Keiji
Department of Anesthesiology & Intensive Care Medicine, Okayama University Graduate School of Medicine, Okayama, Japan.
Kyobu Geka. 2008 Jun;61(6):483-90.
Thoracic surgery has become to be performed more safely by recent progress of operative method and anesthetic management. The surgery can be applicable for those patients who were formerly difficult for operation because of preoperative poor respiratory function, however, postoperative mortality and morbidity increase in such patients without appropriate perioperative management. Experienced anesthetic management can contribute to the risk reduction for these conditions. Since respiratory function which is injured by associated diseases is worsen by both thoracic surgery and general anesthesia, patients with coexisting respiratory diseases in particular need to be watched out intensively. Coherent risk management from preoperative to postoperative period becomes important. This is achieved by the comprehensive perioperative patient management which is consisted of the cooperation between the surgeon and the anesthetist, correct preoperartive evaluation, preoperative medical treatment with pulmonary rehabilitation, appropriate anesthetic management, and postoperative intensive care.
随着手术方法和麻醉管理的最新进展，胸外科手术已变得更加安全。该手术适用于那些因术前呼吸功能差而以前难以进行手术的患者，然而，如果没有适当的围手术期管理，这些患者的术后死亡率和发病率会增加。经验丰富的麻醉管理有助于降低这些情况的风险。由于相关疾病所损伤的呼吸功能会因胸外科手术和全身麻醉而恶化，因此尤其需要密切关注并存呼吸系统疾病的患者。从术前到术后阶段进行连贯的风险管理变得很重要。这通过由外科医生和麻醉师之间的合作、正确的术前评估、术前肺部康复治疗、适当的麻醉管理以及术后重症监护组成的全面围手术期患者管理来实现。
