The Annals of thoracic surgery
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Local gentamicin reduces sternal wound infections after cardiac surgery: a randomized controlled trial.
Sternal wound infections remain a major cause of morbidity after cardiac surgery. Vancomycin is often the only effective antibiotic available for their treatment but its use for routine prophylaxis is inadvisable for ecological reasons. Local application of gentamicin produces high antibiotic concentrations in the wound. We aimed to determine whether this treatment could have an additive effect on the incidence of sternal wound infections when combined with routine prophylaxis. ⋯ Local collagen-gentamicin reduced the risk for postoperative sternal wound infections. Further studies are warranted to confirm these results, particularly with regard to deep infections.
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Temporary epicardial pacing wires are used routinely after coronary artery bypass graft (CABG) surgery and can cause rare, catastrophic complications. This study's purpose was to identify patient characteristics predicting the need for pacing after CABG surgery with the potential to limit their utilization. ⋯ Few patients require temporary epicardial pacing after routine CABG. This study identified specific predictors for postoperative pacing requirements and provides criteria for the selective use of epicardial pacing wires after CABG.
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Review
Good long-term outcomes after surgical treatment of simple and complex pulmonary aspergilloma.
The long-term outcomes of pulmonary aspergilloma have been known to depend on the underlying lung disease. We analyzed the surgical long-term outcomes for both simple and complex aspergilloma. ⋯ Although the postoperative morbidity rate was higher in complex aspergilloma, surgical treatment for both simple and complex aspergilloma could achieve satisfactory long-term outcomes in selected groups of patients.
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Multicenter Study
Lung cancer and its operable brain metastasis: survival rate and staging problems.
We assessed the survival rates regarding different stages of operable lung cancers causing operable brain metastasis in patients with or without cancer-related symptoms. The correlation between survival rates and the disease-free interval between lung surgery and metastasectomy was studied. ⋯ The 5-year survival rate in stage I, II, IIIA, and IV lung cancer with operable hematogenous brain metastases corresponds to that in the customary stage IIIA (23%). The disease-free interval exhibited no significant impact on the survival rate. The complaint-free status exhibits a significantly greater impact on the survival rate in hematogenic metastasis.
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Review Meta Analysis Comparative Study
Is virtual bronchoscopy an efficient diagnostic tool for the thoracic surgeon?
Virtual bronchoscopy has emerged over the past decade as a potentially complementary investigation to conventional bronchoscopy in the diagnosis, grading, and monitoring of pulmonary disease. A meta-analysis reporting on the use of virtual bronchoscopy has not yet been performed. The primary aim of this study is to evaluate its diagnostic accuracy compared to the gold standard investigation of conventional bronchoscopy (fiberoptic or rigid). ⋯ The calculated pooled sensitivity was 84% (95% CI, 78% to 89%), specificity 75% (95% CI, 62% to 85%) and area under the curve was 0.92, which shows good diagnostic performance. Meta-analysis confirms virtual bronchoscopy is very discriminating in the evaluation of patients with significant airway stenosis that is due to a wide spectrum of pathologic conditions. It can potentially have a beneficial role in selected thoracic patients (with bronchoesophageal fistulas, postlung transplantation, anastomoses, and suspected foreign body aspiration).