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Complications are not common but include infection, lung abscess, and bronchopleural fistula (a fistula between the pleural space and the bronchial tree). [4] A bronchopleural fistula results when there is a communication between the laceration, a bronchiole, and the pleura; it can cause air to leak into the pleural space despite the placement of a chest tube. [4]
Pulmonary contusion results in bleeding and fluid leakage into lung tissue, which can become stiffened and lose its normal elasticity. The water content of the lung increases over the first 72 hours after injury, potentially leading to frank pulmonary edema in more serious cases. [ 20 ]
Lung surgery is a type of thoracic surgery involving the repair or removal of lung tissue, [1] and can be used to treat a variety of conditions ranging from lung cancer to pulmonary hypertension. Common operations include anatomic and nonanatomic resections, pleurodesis and lung transplants .
A common complication after thoracic surgery that arises within 30–50% of patients are air leaks. If a chest tube clogs when there is an air leak the patient will develop a pneumothorax. This can be life-threatening. [ 12 ]
The pathophysiology of type 3 respiratory failure often includes lung atelectasis, which is a term used to describe a collapsing of the functional units of the lung that allow for gas exchange. Because atelectasis occurs so commonly in the perioperative period, this form is also called perioperative respiratory failure.
Cardiac surgery training in the United States is combined with general thoracic surgery and called cardiothoracic surgery or thoracic surgery. A cardiothoracic surgeon in the U.S. is a physician who first completes a general surgery residency (typically 5–7 years), followed by a cardiothoracic surgery fellowship (typically 2–3 years).
In a pneumonectomy, in which an entire lung is removed, the remaining bronchial stump may leak air, a rare but very serious condition that leads to progressive subcutaneous emphysema. [8] Air can leak out of the pleural space through an incision made for a thoracotomy to cause subcutaneous emphysema. [ 8 ]
In some lung-disease patients, the lung will not expand after removal of the pleural peel, rendering the surgery futile. Other diseases that render decortication futile are narrowing of the large airway stenosis and uncontrolled pleural infection. With these conditions, the lung will not expand to fill the thorax space.