Benefits of Aggressive Perioperative Management in Patients Undergoing Thoracotomy

¹ From the Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston

With lung resection remaining the cornerstone of curative therapy in patients with lung cancer, aggressive perioperative management continues to play a critical role. This review summarizes the most important factors in successful perioperative management. These include patient selection, with an emphasis on which patient variables and hemodynamic assessments are most useful in determining operability. Postoperative management, in particular, patient-controlled analgesia, and pulmonary toilet, are essential to facilitate early patient mobility and to minimize complications, respectively. Aggressive perioperative management can result in reduced postoperative morbidity and mortality, reduced length of hospital stay and expenditures for complications, and it expands the population that can receive potentially curative therapy.