Diagnostic Procedures

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• QHow can opioid dependency following lung surgery be prevented?

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  A The Society of Thoracic Surgeons answered

  To prevent opioid dependency following lung surgery it is vitally important for people to discuss pain management with their surgeon and other healthcare providers prior to surgery. Together with their surgeon, people undergoing lung surgery should develop a plan to appropriately manage their pain while also minimizing their risk of taking these medications for longer than intended after surgery. Issues that should be discussed include the following:

  • details of the surgical operation
  • the risks of using opioids
  • alternatives to opioids for pain management
  • the person's expectations for pain after surgery
  • instructions for the proper disposal of unused pills
• QWhat are the risk factors for opioid dependency following lung surgery?

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  A The Society of Thoracic Surgeons answered

  Risk factors for opioid dependency following lung surgery include the following:

  • open, traditional lung resection with a large incision
  • male sex
  • age less than 64 years
  • income less than $70,000
  • past history of substance abuse
  • hospital stay of more than five days after surgery
  • postoperative chemotherapy or radiation
• QCan the type of lung surgery I have influence my risk of opioid dependency?

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  A The Society of Thoracic Surgeons answered

  The type of lung surgery you have can influence your risk of opioid dependency. The results of a comprehensive study showed that people who underwent an open, traditional lung resection with a large incision had nearly double the risk of becoming long-term opioid users in comparison to those who received their operations via a minimally invasive approach such as video-assisted thoracoscopic surgery (VATS). The researchers found that 17 percent of people who underwent a traditional lung operation went on to become new persistent opioid users, compared to 9 percent of the people who received a minimally invasive lung surgery.

• QWhat is the risk of opioid dependency following lung surgery?

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  A The Society of Thoracic Surgeons answered

  Many people become opioid dependent following lung surgery. While the use of opioids after lung surgery is intended as a short-term strategy to relieve pain, many people who weren’t prior opioid users continue to take the medication for several months after their lung operations, becoming dependent and “persistent opioid users."

  A study was conducted in which data from people with cancer between January 2010 and June 2014 was evaluated using an insurance claims database. The database contained information from more than 100 health plans in the United States. A total of 3,026 people who received an operation to remove part of the lung (lung resection) and were “opioid naïve” were included in the study.

  The researchers found that one in seven people (14 percent) became new persistent opioid users after surgery, establishing opioid addiction as a postoperative complication that is as common as others, including atrial fibrillation. According to the researchers, “new persistent opioid users” describes people who were not taking opioids before surgery, underwent surgery, took opioid pain medication, and continued to use the opioid prescription after the operation, even after all wounds had healed and physical recovery was complete.

  The research highlights one pathway for long-term opioid use: opioid users who begin taking the pills following a surgical operation.

• QWhat is endoscopic ultrasonography?

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  A Dr. Daniel R. Spogen, MD , Family Medicine, answered on behalf of Univ. of Nev. School of Medicine, Family Medicine

  During endoscopic ultrasonography (EUS) a scope is used to initially find the correct positioning within the gastrointestinal (GI) tract being studied. The scope will have an ultrasound probe as part of its mechanism. Once the area to be examined is found (mass, organ of interest, etc.), then the ultrasound probe is turned on and the ultrasound is used to examine structures within and just outside of the wall of the GI tract. It is helpful in examining and biopsying masses located within or outside of the GI tract that previously would have needed surgery to access. It is also very helpful in staging GI tract cancers as the ultrasound will show how deep the mass is and whether it is invading other structures.

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• QWhat is an endoscopy?

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  A Discovery Health answered

  An endoscopy is a test used to evaluate the extent of damage to the tissue in the esophagus. During the test, a tube slides down the throat. Too much damage puts you at risk for a precancerous condition called Barrett's esophagus and for esophageal cancer. Depending on the damage, a doctor might recommend surgery to reinforce the esophageal sphincter, a valve that, when faulty, causes stomach acid to back into the esophagus.

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• QWhat should I expect after a thoracentesis?

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  A Aurora Health Care answered

  After a thoracentesis -- a procedure in which fluid is taken from the chest cavity to relieve pressure on the diaphragm to help you breathe easier -- your blood pressure, pulse, and respirations will be taken. A dressing will be applied to the puncture area. You will be observed for a short period of time depending on your doctor's orders. You will be sent for a chest x-ray.
  
  You may feel fatigued after the procedure, so rest at home. You may eat and drink as usual unless given other instructions. If you have questions or concerns, call your doctor or the clinic where the procedure was done.
• QWhat are the pitfalls of capsule endoscopy?

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  A Dr. Mehmet Oz, MD , Cardiology (Cardiovascular Disease), answered

  Unfortunately capsule endoscopy can miss a lot and it doesn't have the accuracy of a doctor-guided colonoscopy, where the doctor can manipulate the device to get sight of hard-to-reach corners. Bowel prep is required and critical to finding masses, and a standard colonoscopy will be required to remove any found polyps.

• QWhich endoscopy procedures are used to visualize the colon?

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  A Dr. Mehmet Oz, MD , Cardiology (Cardiovascular Disease), answered

  Doctors often rely on an endoscope to visualize the inside of the body. A long flexible tube fixed with a tiny fiber optic camera is threaded into an opening to illuminate and magnify the tissue while it is displayed on a computer screen. There are two procedures that visualize the colon using endoscopes, a colonoscopy and a sigmoidoscopy.

• QWhat is the difference between an endoscopy and a capsule endoscopy?

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  A Dr. Michael J. Albertson, MD , Gastroenterology, answered on behalf of UCLA Health

  The difference between an endoscopy and a capsule endoscopy is the way in which each procedure is performed. In an endoscopy, a long thin tube with a camera on the end is passed into the body and produces images of the intestines on a monitor. The endoscope can also be used to perform a biopsy if necessary.
   
  In a capsule endoscopy, you swallow a pill containing a miniature camera and then wear a special vest throughout the day that records images from the camera. If a biopsy is needed, however, it must be done in a separate procedure.