[Major surgery of the thoracic wall: preoperative preparation, peri-and postoperative care]

Major chest wall surgery causes significant changes in respiratory function during the peri- and postoperative phases. These are predominantly due to lateral position, use of a double lumen endotracheal tube, one-lung anesthesia, loss of functional intrathoracic volume, postoperative pain and local hypoventilation, pulmonary superinfection and right heart dysfunction. In the present short review pathophysiological mechanisms, appropriate monitoring techniques and some therapeutic modalities are discussed.