Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · May 2011
The use of cell salvage in routine cardiac surgery is ineffective and not cost-effective and should be reserved for selected cases.
The reported benefits of intraoperative cell salvage are decreased requirement for blood transfusion and cost-effectiveness. This study was designed to challenge this hypothesis. ⋯ We conclude that the routine use of cell savers in all cardiac operations affords no benefit and consumes additional revenue. We recommend that the system only be considered in selected high-risk cases or complex procedures.
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Interact Cardiovasc Thorac Surg · May 2011
Stenting of the descending thoracic aorta: a six-year single-center experience.
The aim of this study was to review the six-year results of the endovascular repair of descending thoracic aortic pathologies, reporting the early perioperative outcomes as well as the mid-term follow-up of the treated patients. ⋯ The endovascular repair of descending thoracic aortic pathologies seems to be a well-established method, with favorable morbidity and mortality rates, at least for 30 days and in the mid-term. Taking into account the potential of a wide application of the endovascular technique in many vascular centers, stenting of the thoracic aorta might offer an overall better solution for patients suffering from these devastating pathologies.
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Interact Cardiovasc Thorac Surg · May 2011
Validation of pN2 sub-classifications in patients with pathological stage IIIA N2 non-small cell lung cancer.
Optimal surgical treatment for patients with stage IIIA N2 non-small cell lung cancer (NSCLC) remains a matter of debate, because of the outcomes. The outcomes may be affected from variations in patterns of lymph node metastasis. As the patterns of lymph node sub-classifications, multiple station metastases of mediastinal lymph nodes (MN2), highest metastasis of the mediastinal lymph nodes (HM), distribution of metastatic nodes (skip N2 or non-skip N2), and clinical (c-) N factor have been cited. ⋯ Based on log-rank testing, c-T factor (P = 0.022), p-T factor (P = 0.0002), c-N factor (P = 0.009), HM (P = 0.019) and skip N2 (P = 0.030) were identified as significantly prognostic. Using these variables, p-T factor, c-N factor and skip N2 showed significance and independence on Cox multivariate analysis. The sub-classification of lymph node metastasis in patients with p-stage IIIA N2 NSCLC has clinical implications for the prognosis.