Correct!
4. Oncology consult
Owing to the rarity of metastatic uroepithelial carcinoma, there are insufficient data to provide strong recommendations (1). However, the results of recent multicentre studies are now available and cisplatinum-based chemotherapy is usually recommended. There are also data suggesting that resection of a solitary pulmonary metastasis may improve survival. However, these are judgement calls and oncology consultation would usually be advised. Oncology did recommend left upper lobectomy followed by chemotherapy. Thoracic surgery was consulted and the patient was thought to be a good lobectomy candidate. A left upper lobe robotic lobectomy performed without evidence of complication.
A postoperative chest x-ray is shown in Figure 3.
Figure 3. Post-operative portable chest x-ray showing some increased left basal consolidation and small apical pneumothorax.
Overnight, the patient became hypotensive (BP 90/60).
What should be done at this time? (Click on the correct answer to be directed to the fifth of eight pages)