Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · May 2010
Results of a surgical resection of pulmonary metastasis from malignant head and neck tumor.
There have been only a few reports about a surgical resection of pulmonary metastasis from malignant head and neck tumor. Here we investigate the survival after a pulmonary metastasectomy, and discuss the prognostic factors. We retrospectively reviewed 25 patients who underwent a pulmonary metastasectomy from malignant head and neck tumor at Kyushu University Hospital from 1981 through 2008. ⋯ Both age (older than 60 years) (P=0.0189) and pulmonary metastases from squamous cell carcinomas in either oral cavity or pharyngeal region (P=0.0002) were identified to be adverse prognostic factors. To obtain a long survival, a positive surgical resection is considered to be an effective and standard treatment for pulmonary metastasis from malignant head and neck tumor. It is also necessary, however, to elucidate fully the primary site and histology of such pulmonary metastasis.
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Interact Cardiovasc Thorac Surg · May 2010
Comparative StudyThe role of EuroSCORE in patients undergoing off-pump coronary artery bypass.
European System for Cardiac Operative Risk Evaluation (EuroSCORE) has been used to predict the postoperative mortality rate for patients undergoing open-heart surgery. The contributions of EuroSCORE in off-pump coronary artery bypass grafting (CABG) has not yet clearly elucidated. ⋯ In off-pump CABG, EuroSCORE can, but not as good as in on-pump CABG, predict mortality, certain major postoperative complications, and postoperative recovery. This suggests off-pump technique appears to modify the risk stratification of the patients undergoing CABG.
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Interact Cardiovasc Thorac Surg · May 2010
Comparative StudyImpact of number and site of lymph node invasion on survival of adenocarcinoma of esophagogastric junction.
Lymph node involvement in adenocarcinoma of the esophagogastric junction (EGJ) is similar to that of gastric cancer. The impact on survival of the number and site of lymph nodes involved in a subgroup of patients undergone surgery for adenocarcinoma of EGJ is reported. Sixty-four patients undergone transthoracic esophagectomy with two-field lymphadenectomy for adenocarcinoma of the EGJ were retrospectively assessed. ⋯ Overall survival was different depending on the infiltration of distal or proximal site nodes, 23% vs. 58% (P<0.05); in N0 patients it was related to the number of lymph nodes removed (83% >15 vs. 57% <15, P<0.05). Classification of lymph node involvement in adenocarcinoma of the EGJ by gastric cancer criteria is adequate for prognostic purposes. The involvement of distal nodes in all cases and the removal of <15 nodes in N0 group resulted as independent negative predictive factors.
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Interact Cardiovasc Thorac Surg · Apr 2010
ReviewDo bigger hospitals or busier surgeons do better adult aortic or mitral valve operations?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether there is a relationship between hospital or surgeon volume (SV) and postoperative outcome in adult aortic or mitral valve surgery. One hundred and sixty papers were found using the specified search strategy, of which seven papers represented the best evidence to answer this question. ⋯ We conclude that regionalisation of adult aortic or mitral valve surgery based on such a limited number of modest quality studies would be an indefensible policy. The implementation of such a scheme can have many clinical, practical, economical and political consequences which have not been examined prospectively until today. Furthermore, the relationship between volume and other outcomes rather than mortality needs further assessment.