The Annals of thoracic surgery
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Controlled Clinical Trial
Adjuvant chemotherapy with 5-fluorouracil and cisplatin in lymph node-positive thoracic esophageal squamous cell carcinoma.
In this study we explored the effectiveness of adjuvant chemotherapy in node-positive, resected thoracic esophageal squamous cell carcinoma patients. ⋯ This study suggests that the postoperative chemotherapy may prolong disease-free survival in lymph node-positive, curatively resected esophageal cancer patients. The postoperative treatment modality for esophageal cancer patients should be determined according to the lymph node status and a randomized phase III clinical trial is warranted using adjuvant chemotherapy if the esophageal cancer is lymph node-positive.
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The surgical repair of aortic coarctation in infants has evolved over time. This study evaluates our current approach utilizing extended end-to-end anastomosis without prosthetic material to enlarge all areas of aortic arch hypoplasia. ⋯ Tailored surgical repair for aortic coarctation has a low rate (6%) of residual and recurrent coarctation even when performed in infants. Mortality and morbidity are low.
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Intercostal nerve blockade for postthoracotomy pain relief can be accomplished by continuous infusion of local anesthetics through a catheter in the subpleural space or through an interpleural catheter, by cryoanalgesia, and by a direct intercostal nerve block. A systematic review of randomized studies indicates that an extrapleural infusion is at least as effective as an epidural and significantly better than narcotics alone. The other techniques of intercostal blockade do not offer an advantage over narcotics alone.
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Comparative Study Clinical Trial
Serum S-100 beta protein during coronary artery bypass graft surgery with or without cardiopulmonary bypass.
Brain damage is a serious complication of cardiac anesthesia. The purpose of this study was to detect brain damage at different surgical stages during coronary artery bypass graft with or without cardiopulmonary bypass. ⋯ This prospective study has shown that serum S-100 beta protein was not only higher than baseline both after cardiopulmonary bypass and on the day after surgery in both groups of patients but it was also significantly increased before cardiopulmonary bypass or manipulation of the heart or aorta. These findings may have implications for anesthesiologic care during the total course of cardiac surgery.