The Annals of thoracic surgery
-
Meta Analysis
Sleeve lobectomy or pneumonectomy: optimal management strategy using decision analysis techniques.
The choice between sleeve lobectomy and pneumonectomy is controversial for patients with early-stage lung cancer and who have acceptable lung function. ⋯ In patients with anatomically appropriate early-stage lung cancer, sleeve lobectomy offers better long-term survival and quality of life than does pneumonectomy and is more cost effective.
-
Comparative Study
Lung resection for non-small-cell lung cancer in patients older than 70: mortality, morbidity, and late survival compared with the general population.
Operative mortality and morbidity in elderly patients operated on for non-small-cell lung cancer are acceptable. However, risk factors for hospital mortality and the benefits for the patients in the long term are insufficiently defined, and survival compared with the general population is not known. ⋯ Pulmonary resection for non-small-cell lung cancer in patients older than 70 years shows acceptable morbidity and mortality. The Charlson index is a better predictor of complications than individual risk factors. In time survival is no longer correlated with the disease but follows the same pattern as the general population.
-
We analyzed our 22 years of experience with extraanatomic bypass grafting for repair of aortic arch coarctation in adults. Results from early and midterm follow-up with clinical evaluation and magnetic resonance angiography are reported. ⋯ Extraanatomic ascending aorta-to-descending thoracic aorta bypass grafting for repair of aortic arch coarctation in adults is safe, with low morbidity and no mortality. The favorable midterm results indicate this technique is a safe and less invasive means of repairing aortic arch coarctation or recoarctation in adults.
-
Calcifying fibrous pseudotumor is a rare lesion recently reported in the literature. We report a new case occurring in the pleura, which is an unusual location. The patient, a 38-year-old woman, had a left pleural mass revealed by chest roentgenograms. ⋯ The pathogenesis is discussed but remains uncertain. Tumor resection appears to be the best option and the clinical course is benign. However, the number of cases to date is insufficient to establish therapeutic recommendations.
-
Progression of empyema, with the development of fibrinous adhesions and loculations, makes simple drainage difficult or impossible. The appropriate management remains controversial. Intrapleural fibrinolytic treatment to facilitate drainage of loculated empyema instead of open thoracotomy has been advocated since the 1950s. The aim of this study was to assess the effectiveness of intrapleural fibrinolytic treatment in postpneumonic pediatric empyemas. ⋯ In all patients with loculations except those with a bronchopleural fistula, intrapleural fibrinolytic treatment should be tried. Thus, the majority of children with loculated empyemas can be treated successfully without invasive interventions, such as thoracoscopic debridements or open surgery.