TY - JOUR
T1 - Anaesthetic and perioperative considerations for extrapleural pneumonectomy and extended pleurectomy/decortication
T2 - A scoping review protocol
AU - Yip, Sui Wah Sean
AU - Weinberg, Laurence
AU - Gooi, Julian
AU - Sivenayagam, Siven
AU - Coulson, Tim G.
AU - Barnett, Stephen A.
AU - Knight, Simon R.
AU - Ludski, Jarryd
AU - Lee, Dong Kyu
N1 - Publisher Copyright:
© 2024 Author(s). Published by BMJ.
PY - 2024/5/16
Y1 - 2024/5/16
N2 - Introduction Extrapleural pneumonectomy (EPP) and extended pleurectomy/decortication (ePD) are surgical cytoreductive techniques aimed at achieving macroscopic resection in malignant pleural tumours such as pleural mesothelioma, non-mesothelioma pleural malignancies such as thymoma and sarcoma, and rarely for pleural tuberculosis, in a more limited fashion. Despite extensive studies on both surgical techniques and consequences, a significant knowledge gap remains regarding how best to approach the perioperative anaesthesia challenges for EPP and ePD. It is unknown if the risk stratification processes for such surgeries are standardised or what types of functional and dynamic cardiac and pulmonary tests are employed preoperatively to assist in the perioperative risk stratification. Further, it is unknown whether the types of anaesthesia and analgesia techniques employed, and the types of haemodynamic monitoring tools used, impact on outcomes. It is also unknown whether individualised haemodynamic protocols are used to guide the rational use of fluids, vasoactive drugs and inotropes. Finally, there is a dearth of evidence regarding how best to monitor these patients postoperatively or what the most effective enhanced recovery protocols are to best mitigate postoperative complications and accelerate hospital discharge. To increase our knowledge of the perioperative and anaesthetic treatment for patients undergoing EPP/ePD, this scoping review attempts to synthesise the literature and identify these knowledge gaps. Methods and analysis This scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Review Protocols methodology. Electronic databases, OVID Medline, EMBASE and the Cochrane Library, will be systematically searched for relevant literature corresponding to EPP or ePD and perioperative or anaesthetic management. Data will be analysed and summarised descriptively and organised according to the three perioperative stages: preoperative, intraoperative and postoperative factors in clinical care. Ethics and dissemination Ethics approval was not required. The findings will be disseminated through professional networks, conference presentations and publications in scientific journals.
AB - Introduction Extrapleural pneumonectomy (EPP) and extended pleurectomy/decortication (ePD) are surgical cytoreductive techniques aimed at achieving macroscopic resection in malignant pleural tumours such as pleural mesothelioma, non-mesothelioma pleural malignancies such as thymoma and sarcoma, and rarely for pleural tuberculosis, in a more limited fashion. Despite extensive studies on both surgical techniques and consequences, a significant knowledge gap remains regarding how best to approach the perioperative anaesthesia challenges for EPP and ePD. It is unknown if the risk stratification processes for such surgeries are standardised or what types of functional and dynamic cardiac and pulmonary tests are employed preoperatively to assist in the perioperative risk stratification. Further, it is unknown whether the types of anaesthesia and analgesia techniques employed, and the types of haemodynamic monitoring tools used, impact on outcomes. It is also unknown whether individualised haemodynamic protocols are used to guide the rational use of fluids, vasoactive drugs and inotropes. Finally, there is a dearth of evidence regarding how best to monitor these patients postoperatively or what the most effective enhanced recovery protocols are to best mitigate postoperative complications and accelerate hospital discharge. To increase our knowledge of the perioperative and anaesthetic treatment for patients undergoing EPP/ePD, this scoping review attempts to synthesise the literature and identify these knowledge gaps. Methods and analysis This scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Review Protocols methodology. Electronic databases, OVID Medline, EMBASE and the Cochrane Library, will be systematically searched for relevant literature corresponding to EPP or ePD and perioperative or anaesthetic management. Data will be analysed and summarised descriptively and organised according to the three perioperative stages: preoperative, intraoperative and postoperative factors in clinical care. Ethics and dissemination Ethics approval was not required. The findings will be disseminated through professional networks, conference presentations and publications in scientific journals.
KW - Adult anaesthesia
KW - Adult intensive & critical care
KW - Anaesthesia in oncology
KW - Patient-Centered Care
KW - SURGERY
KW - Thoracic medicine
UR - http://www.scopus.com/inward/record.url?scp=85193608326&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2023-078125
DO - 10.1136/bmjopen-2023-078125
M3 - Article
C2 - 38760041
AN - SCOPUS:85193608326
SN - 2044-6055
VL - 14
JO - BMJ Open
JF - BMJ Open
IS - 5
M1 - e078125
ER -