Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Jul 2015
Predictors of post-recurrence survival in patients with non-small-cell lung cancer initially completely resected.
Despite recent progress in diagnostic technology and therapeutic approaches to non-small-cell lung cancer (NSCLC), 30-75% of patients develop tumour recurrence after resection. However, the details of post-recurrence survival (PRS) are not well understood. We aimed to investigate the predictors of PRS in patients with NSCLC initially completely resected. ⋯ The current results showed that non-adenocarcinoma histology, elevated serum CEA at recurrence and no systemic chemotherapy were independent unfavourable post-recurrence prognostic factors. The current data can be informative for patient follow-up after complete resection and further clinical investigation may give us more information about PRS and accurate treatment strategy for recurrent NSCLC after initial complete resection.
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Interact Cardiovasc Thorac Surg · Jul 2015
ReviewIs the learning curve for video-assisted thoracoscopic lobectomy affected by prior experience in open lobectomy?
A best evidence topic was written according to a structured protocol. The question addressed is the learning curve for video-assisted thoracoscopic (VATS) lobectomy affected by prior experience in open lobectomy? Two hundred and two studies were identified of which seven presented the best evidence on the topic. The authors, date, journal, country of publication, study type, participating surgeon and relevant outcomes are tabulated. ⋯ Four trainee surgeons who had performed at least 50 open pulmonary resections each managed to achieve a similar mean operative time to their consultant in their first 46 cases, and a lower morbidity (26 vs 34.7%). There was no increase in mortality in the trainee groups. Surgeons with limited experience in open lobectomy can achieve good outcomes in VATS lobectomy comparable with their more experienced seniors.
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Interact Cardiovasc Thorac Surg · Jul 2015
Efficacy of adjuvant chemotherapy for lung adenocarcinoma patients with positive pleural lavage cytology findings.
Positive pleural lavage cytology (PLC) findings are considered to be predictive of a poor prognosis in patients with non-small-cell lung cancer (NSCLC). We investigated the clinical benefit of adjuvant chemotherapy for lung adenocarcinoma patients with positive PLC findings. ⋯ Adjuvant chemotherapy for lung adenocarcinoma patients with positive PLC findings significantly improved recurrence-free survival.
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Interact Cardiovasc Thorac Surg · Jul 2015
Observational StudyPreoperative frontal QRS-T angle is an independent correlate of hospital length of stay and predictor of haemodynamic support requirement following off-pump coronary artery bypass graft surgery.
With the adoption of novel operative techniques and aggressive care protocols that facilitate earlier extubation and mobilization of patients, postoperative length of stay (LOS) following coronary artery bypass graft surgery (CABG) has declined. However, there is paucity of information regarding preoperative electrocardiographic predictors of LOS following CABG. In this study, we investigated whether frontal QRS-T angle, which is an abnormal repolarization marker in prediction of various cardiovascular events, was an independent correlate of postoperative hospital LOS for off-pump CABG. Furthermore, we evaluated independent predictors of vasopressor agent/intra-aortic balloon pump (IABP) support requirement following off-pump CABG. ⋯ Prediction of the hospital LOS and patient outcome following CABG is of great importance. Being easily obtainable via standard 12-lead electrocardiogram and its low cost may make frontal QRS-T angle a beneficial marker for reducing both patient-based morbidity and economic burden.
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Interact Cardiovasc Thorac Surg · Jul 2015
Percutaneous dilatational tracheostomy following total artificial heart implantation.
Coagulation disorders and an immune-altered state are common among total artificial heart patients. In this context, we sought to evaluate the safety of percutaneous dilatational tracheostomy in cases of prolonged need for mechanical ventilatory support. We retrospectively analysed the charts of 11 total artificial heart patients who received percutaneous dilatational tracheostomy. ⋯ Late complications, including subglottic stenosis, stomal infection or infections of the lower respiratory tract, were not observed. In conclusion, percutaneous dilatational tracheostomy in total artificial heart patients is safe. Considering the well-known benefits of early tracheotomy over prolonged translaryngeal intubation, we advocate early timing of therapy in cases of prolonged mechanical ventilation.