{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T22:16:57Z","timestamp":1793744217856,"version":"4.6.1"},"reference-count":57,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T00:00:00Z","timestamp":1715817600000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,5,5]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>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.<\/jats:p><jats:p>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.<\/jats:p><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and analysis<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Ethics and dissemination<\/jats:title><jats:p>Ethics approval was not required. The findings will be disseminated through professional networks, conference presentations and publications in scientific journals.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2023-078125","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T06:25:16Z","timestamp":1715927116000},"page":"e078125","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Anaesthetic and perioperative considerations for extrapleural pneumonectomy and extended pleurectomy\/decortication: a scoping review protocol"],"prefix":"10.1136","volume":"14","author":[{"given":"Sui Wah Sean","family":"Yip","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7403-7680","authenticated-orcid":false,"given":"Laurence","family":"Weinberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Gooi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siven","family":"Sivenayagam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim G","family":"Coulson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen A","family":"Barnett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon R","family":"Knight","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8076-6804","authenticated-orcid":false,"given":"Jarryd","family":"Ludski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4068-2363","authenticated-orcid":false,"given":"Dong Kyu","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,5,16]]},"reference":[{"key":"2024051623250664000_14.5.e078125.1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.31.1.15"},{"key":"2024051623250664000_14.5.e078125.2","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.21037\/jtd.2019.02.61","article-title":"Extra-pleural Pneumonectomy","volume":"11","author":"Duranti","year":"2019","journal-title":"J Thorac Dis"},{"key":"2024051623250664000_14.5.e078125.3","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e3182208e3f"},{"key":"2024051623250664000_14.5.e078125.4","doi-asserted-by":"crossref","DOI":"10.21037\/atm.2017.03.82","article-title":"Extrapleural Pneumonectomy (EPP) vs. Pleurectomy Decortication (P\/D)","volume":"5","author":"Batirel","year":"2017","journal-title":"Ann Transl Med"},{"key":"2024051623250664000_14.5.e078125.5","doi-asserted-by":"publisher","DOI":"10.1136\/thx.4.4.173"},{"key":"2024051623250664000_14.5.e078125.6","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.thorsurg.2014.07.014","article-title":"Extrapleural Pneumonectomy for pleural malignancies","volume":"24","author":"Wolf","year":"2014","journal-title":"Thorac Surg Clin"},{"key":"2024051623250664000_14.5.e078125.7","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70149-8"},{"key":"2024051623250664000_14.5.e078125.8","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e3181ed0489"},{"key":"2024051623250664000_14.5.e078125.9","first-page":"523","article-title":"Extrapleural pneumonectomy and extended pleurectomy\/decortication for malignant pleural Mesothelioma: the memorial sloan-kettering cancer center approach","volume":"1","author":"Rusch","year":"2012","journal-title":"Ann Cardiothorac Surg"},{"key":"2024051623250664000_14.5.e078125.10","doi-asserted-by":"publisher","DOI":"10.1097\/01243894-200602000-00014"},{"key":"2024051623250664000_14.5.e078125.11","doi-asserted-by":"crossref","first-page":"556","DOI":"10.21037\/tlcr.2018.06.07","article-title":"Extended pleurectomy decortication: the current role","volume":"7","author":"Bilancia","year":"2018","journal-title":"Transl Lung Cancer Res"},{"key":"2024051623250664000_14.5.e078125.12","doi-asserted-by":"crossref","first-page":"550","DOI":"10.21037\/tlcr.2018.07.07","article-title":"Extrapleural pneumonectomy: still indicated","volume":"7","author":"Domen","year":"2018","journal-title":"Transl Lung Cancer Res"},{"key":"2024051623250664000_14.5.e078125.13","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.athoracsur.2021.04.078","article-title":"Extrapleural pneumonectomy versus pleurectomy\/decortication for malignant pleural mesothelioma","volume":"113","author":"Zhou","year":"2022","journal-title":"Ann Thorac Surg"},{"key":"2024051623250664000_14.5.e078125.14","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1093\/icvts\/ivw422","article-title":"Propensity matched comparison of extrapleural pneumonectomy and pleurectomy\/decortication for mesothelioma patients","volume":"24","author":"Kostron","year":"2017","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"2024051623250664000_14.5.e078125.15","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1002\/jso.25260","article-title":"Short-term outcomes of pleurectomy decortication and extrapleural pneumonectomy in mesothelioma","volume":"118","author":"van Gerwen","year":"2018","journal-title":"J Surg Oncol"},{"key":"2024051623250664000_14.5.e078125.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.10.054"},{"key":"2024051623250664000_14.5.e078125.17","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e31824ab6c5"},{"key":"2024051623250664000_14.5.e078125.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2013.11.026"},{"key":"2024051623250664000_14.5.e078125.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.09.056"},{"key":"2024051623250664000_14.5.e078125.20","doi-asserted-by":"publisher","DOI":"10.1200\/JC0.2017.76.6394"},{"key":"2024051623250664000_14.5.e078125.21","doi-asserted-by":"crossref","unstructured":"J\u00e4rvinen T , Paajanen J , Ilonen I , et al . n.d. Hyperthermic intrathoracic chemoperfusion for malignant pleural mesothelioma: systematic review and meta-analysis. Cancers 13:3637. doi:10.3390\/cancers13143637","DOI":"10.3390\/cancers13143637"},{"key":"2024051623250664000_14.5.e078125.22","doi-asserted-by":"crossref","DOI":"10.3390\/jcm11154537","article-title":"Single-center 20-year experience in surgical treatment of malignant pleural mesothelioma","volume":"11","author":"Mangiameli","year":"2022","journal-title":"J Clin Med"},{"key":"2024051623250664000_14.5.e078125.23","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.canrad.2016.09.009","article-title":"Radiation therapy for malignant pleural Mesothelioma","volume":"21","author":"Rosenzweig","year":"2017","journal-title":"Cancer Radiother"},{"key":"2024051623250664000_14.5.e078125.24","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/S0022-5223(19)36578-X","article-title":"Extrapleural Pneumonectomy, chemotherapy, and radiotherapy in the treatment of diffuse malignant pleural Mesothelioma","volume":"102","author":"Sugarbaker","year":"1991","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024051623250664000_14.5.e078125.25","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1080\/17476348.2019.1679119","article-title":"Types of surgery post-Neoadjuvant chemotherapy for pleural mesothelioma","volume":"13","author":"Kuribayashi","year":"2019","journal-title":"Expert Rev Respir Med"},{"key":"2024051623250664000_14.5.e078125.26","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-038892","article-title":"Mesothelioma and radical surgery 2 (MARS 2): protocol for a multicentre randomised trial comparing (extended) pleurectomy decortication versus no (extended) pleurectomy decortication for patients with malignant pleural mesothelioma","volume":"10","author":"Lim","year":"2020","journal-title":"BMJ Open"},{"key":"2024051623250664000_14.5.e078125.27","doi-asserted-by":"crossref","first-page":"1948","DOI":"10.1016\/j.jtcvs.2021.07.043","article-title":"Commentary: a return trip to MARS: less may be more when treating Mesothelioma","volume":"163","author":"Griffin","year":"2022","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024051623250664000_14.5.e078125.28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0022-5223(19)36577-8","article-title":"The role of extrapleural pneumonectomy in malignant pleural mesothelioma. a lung cancer study group trial","volume":"102","author":"Rusch","year":"1991","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024051623250664000_14.5.e078125.29","doi-asserted-by":"crossref","first-page":"2792","DOI":"10.1111\/1759-7714.14627","article-title":"Feasibility and safety of extended pleurectomy\/decortication for malignant pleural Mesothelioma. a single group experience","volume":"13","author":"Falanga","year":"2022","journal-title":"Thorac Cancer"},{"key":"2024051623250664000_14.5.e078125.30","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2016.0087"},{"key":"2024051623250664000_14.5.e078125.31","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1093\/annonc\/mdy195","article-title":"Pleural Mesothelioma: is the surgeon still there","volume":"29","author":"Opitz","year":"2018","journal-title":"Ann Oncol"},{"key":"2024051623250664000_14.5.e078125.32","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2008.01.001"},{"key":"2024051623250664000_14.5.e078125.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.10.041"},{"key":"2024051623250664000_14.5.e078125.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.05.071"},{"key":"2024051623250664000_14.5.e078125.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2004.02.021"},{"key":"2024051623250664000_14.5.e078125.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2006.01.015"},{"key":"2024051623250664000_14.5.e078125.37","doi-asserted-by":"crossref","first-page":"56","DOI":"10.21037\/shc.2018.07.02","article-title":"Complications following radical surgery for malignant pleural Mesothelioma\u2014prevention and management","volume":"2","author":"Di Martino","year":"2018","journal-title":"Shanghai Chest"},{"key":"2024051623250664000_14.5.e078125.38","doi-asserted-by":"crossref","DOI":"10.3390\/jcm10214968","article-title":"Extended pleurectomy\/decortication for malignant pleural mesothelioma: humanitas\u2019s experience","volume":"10","author":"Mangiameli","year":"2021","journal-title":"J Clin Med"},{"key":"2024051623250664000_14.5.e078125.39","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/j.athoracsur.2016.08.071","article-title":"Extended pleurectomy-decortication-based treatment for advanced stage epithelial mesothelioma yielding a median survival of nearly three years","volume":"103","author":"Friedberg","year":"2017","journal-title":"The Annals of Thoracic Surgery"},{"key":"2024051623250664000_14.5.e078125.40","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1053\/j.optechstcvs.2010.12.001","article-title":"Technique of extrapleural pneumonectomy","volume":"15","author":"DaSilva","year":"2010","journal-title":"Operative Techniques in Thoracic and Cardiovascular Surgery"},{"key":"2024051623250664000_14.5.e078125.41","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.thorsurg.2004.06.001","article-title":"Extrapleural pneumonectomy for diffuse malignant pleural Mesothelioma: techniques and complications","volume":"14","author":"Chang","year":"2004","journal-title":"Thorac Surg Clin"},{"key":"2024051623250664000_14.5.e078125.42","first-page":"523","article-title":"Extrapleural pneumonectomy and extended pleurectomy\/decortication for malignant pleural mesothelioma: the memorial sloan-kettering cancer center approach","volume":"1","author":"Rusch","year":"2012","journal-title":"Ann Cardiothorac Surg"},{"key":"2024051623250664000_14.5.e078125.43","doi-asserted-by":"crossref","first-page":"807","DOI":"10.4103\/0019-5049.171574","article-title":"Anaesthetic management of extra-pleural pneumonectomy and hyperthermic intrathoracic chemotherapy procedure","volume":"59","author":"Ramegowda","year":"2015","journal-title":"Indian J Anaesth"},{"key":"2024051623250664000_14.5.e078125.44","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e3282f2a9c3"},{"key":"2024051623250664000_14.5.e078125.45","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.thorsurg.2004.06.005","article-title":"Anesthetic strategies for patients undergoing extrapleural pneumonectomy","volume":"14","author":"Hartigan","year":"2004","journal-title":"Thorac Surg Clin"},{"key":"2024051623250664000_14.5.e078125.46","doi-asserted-by":"crossref","first-page":"29","DOI":"10.2174\/1874321801711010029","article-title":"Clinical pearls in anaesthesia for pleurectomy\/decortication for malignant mesothelioma","volume":"11","author":"Shah","year":"2017","journal-title":"TOATJ"},{"key":"2024051623250664000_14.5.e078125.47","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes124"},{"key":"2024051623250664000_14.5.e078125.48","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1097\/ACO.0000000000000124","article-title":"The role of the anesthesiologist in perioperative patient safety","volume":"27","author":"Wacker","year":"2014","journal-title":"Curr Opin Anaesthesiol"},{"key":"2024051623250664000_14.5.e078125.49","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.bjae.2019.04.004","article-title":"Anaesthesia for pneumonectomy","volume":"19","author":"Hackett","year":"2019","journal-title":"BJA Educ"},{"key":"2024051623250664000_14.5.e078125.50","doi-asserted-by":"crossref","DOI":"10.21037\/atm.2019.03.67","article-title":"Anesthetic considerations for lung resection: preoperative assessment, intraoperative challenges and postoperative analgesia","volume":"7","author":"Lederman","year":"2019","journal-title":"Ann Transl Med"},{"key":"2024051623250664000_14.5.e078125.51","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1177\/1089253220919289","article-title":"Anesthetic approach to postpneumonectomy syndrome","volume":"24","author":"Doan","year":"2020","journal-title":"Semin Cardiothorac Vasc Anesth"},{"key":"2024051623250664000_14.5.e078125.52","doi-asserted-by":"crossref","first-page":"494","DOI":"10.5152\/TJAR.2021.1108","article-title":"Perioperative anaesthesiological management of malignant pleural Mesothelioma patients undergoing Extrapleural Pneumonectomy (EPP) and extended Pleurectomy\/Decortication ((E) PD)","volume":"49","author":"Lauk","year":"2021","journal-title":"Turk J Anaesthesiol Reanim"},{"key":"2024051623250664000_14.5.e078125.53","doi-asserted-by":"crossref","unstructured":"Munn Z , Peters MDJ , Stern C , et al . Systematic review or scoping review? guidance for authors when choosing between a systematic or Scoping review approach. BMC Med Res Methodol 2018;18. doi:10.1186\/s12874-018-0611-x","DOI":"10.1186\/s12874-018-0611-x"},{"key":"2024051623250664000_14.5.e078125.54","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/1364557032000119616","article-title":"Scoping studies: towards a methodological framework","volume":"8","author":"Arksey","year":"2005","journal-title":"International Journal of Social Research Methodology"},{"key":"2024051623250664000_14.5.e078125.55","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-5-69"},{"key":"2024051623250664000_14.5.e078125.56","unstructured":"Fernando J , Alcock D , Yap SJ , et al . In: A framework for perioperative care in Australia and New Zealand In AaNZCoA (ANZCA). Australian and New Zealand College of Anaesthetists, 2021."},{"key":"2024051623250664000_14.5.e078125.57","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-078125","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T06:25:37Z","timestamp":1715927137000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-078125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":57,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5,16]]},"published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1136\/bmjopen-2023-078125"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-078125","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5]]}}}