Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jun 2015
Comparative Study Observational StudyFull sternotomy versus right anterior minithoracotomy for isolated aortic valve replacement in octogenarians: a propensity-matched study †.
Surgical aortic valve replacement (AVR) is increasingly performed in elderly patients with good perioperative outcomes and long-term survival, resulting in significant health-related quality-of-life benefits. This study aimed to evaluate the outcome of patients aged ≥ 80 years undergoing isolated AVR through a right anterior minithoracotomy (RAMT) and compare it with a full sternotomy (FS). ⋯ Minimally invasive AVR through right anterior minithoracotomy can be safely performed in patients aged ≥80 years with acceptable morbidity and mortality rates. It is an expeditious and effective alternative to full sternotomy AVR and might be associated with lower postoperative stroke incidence, earlier extubation and shorter hospital stay.
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Interact Cardiovasc Thorac Surg · Jun 2015
ReviewIs robotic mitral valve surgery more expensive than its conventional counterpart?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Is robotic mitral valve surgery more expensive than its conventional counterpart?' Altogether 19 papers were found using the reported search, of which 5 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. ⋯ The fifth study was a large national database inquiry in which robotic approach was found to be more expensive by US$600 per case excluding amortization cost and by US$3700 if amortization is included. We conclude that the total hospital cost of robotic mitral valve surgery is slightly higher than conventional sternotomy surgery. If amortization is taken into consideration, robotic cases are considerably more expensive.
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Interact Cardiovasc Thorac Surg · Jun 2015
Multicenter StudyClinicopathological characteristics and lymph node metastasis pathway of non-small-cell lung cancer located in the left lingular division.
The purpose of this study is to assess the clinicopathological characteristics of non-small-cell lung cancer (NSCLC) occurring in the left lingular division (LLD) in association with a proposal of the LLD-specific regional lymph node stations. ⋯ An intraoperative pathological examination using our proposed LLD-specific regional lymph node stations may accurately diagnose the status of node metastasis, and appropriately lead to selective or complete MLND in LLD-NSCLC patients with c-T2N1M0 or lower stage disease.
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Interact Cardiovasc Thorac Surg · Jun 2015
Comparative StudyPrognosis of non-small-cell lung cancer patients with positive pleural lavage cytology.
Positive pleural lavage cytology (PLC) is considered as a precursor condition of pleural dissemination (PD) or malignant pleural effusion (PE), and one of the poor prognostic factors in surgically resected non-small-cell lung cancer (NSCLC) patients. Although PD and PE are classified as M1a, PLC does not contribute to the tumour, node and metastasis (TNM) classification of the Union Internationale Contre le Cancer. This study aimed to evaluate the prognostic effect of positive PLC status in surgically resected NSCLC patients compared with PD and/or PE. We also aimed to consider the contribution of positive PLC status to the TNM classification. ⋯ Positive pre-PLC had the significant prognostic effect in surgically resected NSCLC patients. However, it is not a contraindication for surgical resection, unlike PD and/or PE. Our data suggest that positive pre-PLC should be classified as pT3 in next TNM classification.